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Thermal ablation of intrahepatic cholangiocarcinoma: Safety, efficacy, and factors affecting local tumor progression

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Abstract

Purpose

To evaluate the safety and oncologic efficacy of percutaneous thermal ablation of intrahepatic cholangiocarcinoma (ICC) and identify risk factors for local tumor progression (LTP).

Materials and methods

Retrospective review of an institutional tumor ablation registry demonstrated that 20 patients (9 males, 11 females; mean age 62.5 ± 15.8 years) with 50 ICCs (mean size 1.8 ± 1.3 cm) were treated with percutaneous radiofrequency ablation (RFA) or microwave ablation (MWA) between 2006 and 2015. Thirty-eight of the treated ICCs (76%) were metastases that developed after surgical resection of the primary tumor. Patient demographics, procedure technical parameters, and clinical outcomes were reviewed. A Cox proportional hazards model was used to examine the risk of LTP by ablation modality. Survival analyses were performed using the Kaplan–Meier method.

Results

Mean imaging follow-up time was 41.5 ± 42.7 months. Forty-four (88%) ICCs were treated with RFA, and 6 (12%) with MWA. Eleven (22%) cases of LTP developed in 5 (25%) patients. The median time to LTP among these 11 tumors was 7.1 months (range, 2.3–22.9 months). Risk of LTP was not significantly different for ICCs treated with MWA compared to RFA (HR 2.72; 95% CI 0.58–12.84; p = 03.21). Median disease-free survival was 8.2 months (1.1–70.4 months), and median overall survival was 23.6 months (7.4–122.5 months). No major complication occurred.

Conclusions

Percutaneous thermal ablation is a safe and effective treatment for patients with ICCs and may be particularly valuable in unresectable patients, or those who have already undergone hepatic surgery. Tumor size and ablation modality were not associated with LTP, whereas primary tumors and superficially located tumors were more likely to subsequently recur.

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Authors and Affiliations

  1. Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Edwin A. Takahashi, Kristin A. Kinsman, Grant D. Schmit, Thomas D. Atwell, John J. Schmitz, Brian T. Welch, Matthew R. Callstrom & A. Nicholas Kurup

  2. Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA

    Jennifer R. Geske

Authors
  1. Edwin A. Takahashi
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  2. Kristin A. Kinsman
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  3. Grant D. Schmit
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  4. Thomas D. Atwell
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  7. Matthew R. Callstrom
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Corresponding author

Correspondence to Edwin A. Takahashi.

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Conflict of interest

Dr. Callstrom is a consultant for Medtronic, Covidien, Johnson and Johnson and Endocare. The remaining authors declare no conflict of interest.

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Takahashi, E.A., Kinsman, K.A., Schmit, G.D. et al. Thermal ablation of intrahepatic cholangiocarcinoma: Safety, efficacy, and factors affecting local tumor progression. Abdom Radiol 43, 3487–3492 (2018). https://doi.org/10.1007/s00261-018-1656-3

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  • DOI: https://doi.org/10.1007/s00261-018-1656-3

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