Advertisement

Lokoregionäre und lokal ablative Therapien von Lebertumoren

Locoregional and local ablative treatment options for liver tumors

  • 38 Accesses

Zusammenfassung

Die interventionelle Radiologie bietet eine Vielzahl von lokoregionären und lokal ablativen Therapieverfahren zur Behandlung von Lebertumoren. Diese können als eigenständige minimal-invasive Therapien, in Kombination mit anderen Therapien und je nach Tumorstadium kurativ oder palliativ angewendet werden. Im vorliegenden Übersichtsbeitrag stellen wir die verschiedenen Techniken vor und beschreiben den klinischen Stellenwert in der Therapie des hepatozellulären Karzinoms und intrahepatischen cholangiozellulären Karzinoms.

Abstract

Interventional radiology offers a large variety of locoregional and local ablative treatment options for liver tumors. These can be applied as stand-alone minimally invasive procedures or in combination with other treatment options and with curative as well as palliative intent depending on the respective tumor stage. This review article presents the various locoregional and local ablative treatment techniques and describes the clinical value in the treatment of hepatocellular carcinoma and intrahepatic cholangiocarcinoma.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Literatur

  1. 1.

    Vogel A, Cervantes A, Chau I, Daniele B, Llovet J, Meyer T et al (2018) Hepatocellular carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 29:iv238–iv255

  2. 2.

    Greten TF, Malek NP, Schmidt S, Arends J, Bartenstein P, Bechstein W et al (2013) Diagnosis of and therapy for hepatocellular carcinoma. Z Gastroenterol 51:1269–1326

  3. 3.

    Spolverato G, Vitale A, Ejaz A, Kim Y, Maithel SK, Cosgrove DP et al (2015) The relative net health benefit of liver resection, ablation, and transplantation for early hepatocellular carcinoma. World J Surg 39:1474–1484

  4. 4.

    Uhlig J, Sellers CM, Stein SM, Kim HS (2019) Radiofrequency ablation versus surgical resection of hepatocellular carcinoma: contemporary treatment trends and outcomes from the United States National Cancer Database. Eur Radiol 29:2679–2689

  5. 5.

    Chen S, Peng Z, Lin M, Chen Z, Hu W, Xie X et al (2018) Combined percutaneous radiofrequency ablation and ethanol injection versus hepatic resection for 2.1–5.0 cm solitary hepatocellular carcinoma: a retrospective comparative multicentre study. Eur Radiol 28:3651–3660

  6. 6.

    Shady W, Petre EN, Do KG, Gonen M, Yarmohammadi H, Brown KT et al (2018) Percutaneous microwave versus radiofrequency ablation of colorectal liver metastases: ablation with clear margins (A0) provides the best local tumor control. J Vasc Interv Radiol 29:268–275.e1

  7. 7.

    Vogl TJ, Nour-Eldin N‑EA, Hammerstingl RM, Panahi B, Naguib NNN (2017) Microwave ablation (MWA): basics, technique and results in primary and metastatic liver neoplasms - review article. Fortschr Röntgenstr 189:1055–1066

  8. 8.

    Ringe KI, Lutat C, Rieder C, Schenk A, Wacker F, Raatschen H‑J (2015) Experimental evaluation of the heat sink effect in hepatic microwave ablation. PLoS ONE 10:e134301

  9. 9.

    Qian G‑J, Wang N, Shen Q, Sheng YH, Zhao J‑Q, Kuang M et al (2012) Efficacy of microwave versus radiofrequency ablation for treatment of small hepatocellular carcinoma: experimental and clinical studies. Eur Radiol 22:1983–1990

  10. 10.

    Huo YR, Eslick GD (2015) Microwave ablation compared to radiofrequency ablation for hepatic lesions: a meta-analysis. J Vasc Interv Radiol 26:1139–1146.e2

  11. 11.

    Yu J, Yu X‑L, Han Z‑Y, Cheng Z‑G, Liu F‑Y, Zhai H‑Y et al (2017) Percutaneous cooled-probe microwave versus radiofrequency ablation in early-stage hepatocellular carcinoma: a phase III randomised controlled trial. Gut 66:1172–1173

  12. 12.

    Vietti Violi N, Duran R, Guiu B, Cercueil J‑P, Aubé C, Digklia A et al (2018) Efficacy of microwave ablation versus radiofrequency ablation for the treatment of hepatocellular carcinoma in patients with chronic liver disease: a randomised controlled phase 2 trial. Lancet Gastroenterol Hepatol 3:317–325

  13. 13.

    Kamal A, Elmoety AAA, Rostom YAM, Shater MS, Lashen SA (2019) Percutaneous radiofrequency versus microwave ablation for management of hepatocellular carcinoma: a randomized controlled trial. J Gastrointest Oncol 10:562–571

  14. 14.

    Peng Z‑W, Zhang Y‑J, Chen M‑S, Xu L, Liang H‑H, Lin X‑J et al (2013) Radiofrequency ablation with or without transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma: a prospective randomized trial. J Clin Oncol 31:426–432

  15. 15.

    Zhang R, Shen L, Zhao L, Guan Z, Chen Q, Li W (2018) Combined transarterial chemoembolization and microwave ablation versus transarterial chemoembolization in BCLC stage B hepatocellular carcinoma. Diagn Interv Radiol 24:219–224

  16. 16.

    Wang C, Wang H, Yang W, Hu K, Xie H, Hu KQ et al (2015) Multicenter randomized controlled trial of percutaneous cryoablation versus radiofrequency ablation in hepatocellular carcinoma. Hepatology 61:1579–1590

  17. 17.

    Kim R, Kang TW, Cha DI, Song KD, Lee MW, Rhim H et al (2019) Percutaneous cryoablation for perivascular hepatocellular carcinoma: therapeutic efficacy and vascular complications. Eur Radiol 29:654–662

  18. 18.

    Hinrichs JB, Shin H‑O, Kaercher D, Hasdemir D, Murray T, Kaireit T et al (2016) Parametric response mapping of contrast-enhanced biphasic CT for evaluating tumour viability of hepatocellular carcinoma after TACE. Eur Radiol 26:3447–3455

  19. 19.

    Hinrichs JB, Hasdemir DB, Nordlohne M, Schweitzer N, Wacker F, Vogel A et al (2017) Health-related quality of life in patients with Hepatocellular carcinoma treated with initial transarterial chemoembolization. Cardiovasc Intervent Radiol 40:1–8

  20. 20.

    Valle JW, Borbath I, Khan SA, Huguet F, Gruenberger T, Arnold D et al (2016) Biliary cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 27:v28–v37

  21. 21.

    Lo C‑M, Ngan H, Tso W‑K, Liu C‑L, Lam C‑M, Poon RT‑P et al (2002) Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology 35:1164–1171

  22. 22.

    Niessen C, Wiggermann P, Velandia C, Stroszczynski C, Pereira PL (2013) Transarterial chemoembolization—status quo in Germany. Fortschr Röntgenstr 185:1089–1094

  23. 23.

    Lammer J, Malagari K, Vogl T, Pilleul F, Denys A, Watkinson A et al (2010) Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study. Cardiovasc Intervent Radiol 33:41–52

  24. 24.

    Kloeckner R, Weinmann A, Prinz F, Pinto dos Santos D, Ruckes C, Dueber C et al (2015) Conventional transarterial chemoembolization versus drug-eluting bead transarterial chemoembolization for the treatment of hepatocellular carcinoma. BMC Cancer 15:465

  25. 25.

    Han G, Berhane S, Toyoda H, Bettinger D, Elshaarawy O, Chan AWH et al (2019) Prediction of survival among patients receiving transarterial chemoembolization for hepatocellular carcinoma: a response-based approach. Hepatology. https://doi.org/10.1002/hep.31022

  26. 26.

    Llovet JM, Bruix J (2008) Novel advancements in the management of hepatocellular carcinoma in 2008. J Hepatol 48(Suppl 1):S20–S37

  27. 27.

    Lencioni R, de Baere T, Soulen MC, Rilling WS, Geschwind J‑FH (2016) Lipiodol transarterial chemoembolization for hepatocellular carcinoma: a systematic review of efficacy and safety data. Hepatology 64:106–116

  28. 28.

    Marelli L, Stigliano R, Triantos C, Senzolo M, Cholongitas E, Davies N et al (2007) Transarterial therapy for hepatocellular carcinoma: which technique is more effective? A systematic review of cohort and randomized studies. Cardiovasc Intervent Radiol 30:6–25

  29. 29.

    Marquardt S, Kirstein MM, Brüning R, Zeile M, Ferrucci PF, Prevoo W et al (2018) Percutaneous hepatic perfusion (chemosaturation) with melphalan in patients with intrahepatic cholangiocarcinoma: European multicentre study on safety, short-term effects and survival. Eur Radiol 383:2168

  30. 30.

    Kirstein MM, Marquardt S, Jedicke N, Marhenke S, Koppert W, Manns MP et al (2017) Safety and efficacy of chemosaturation in patients with primary and secondary liver tumors. J Cancer Res Clin Oncol 143:2113–2121

  31. 31.

    Kulik LM, Carr BI, Mulcahy MF, Lewandowski RJ, Atassi B, Ryu RK et al (2008) Safety and efficacy of 90Y radiotherapy for hepatocellular carcinoma with and without portal vein thrombosis. Hepatology 47:71–81

  32. 32.

    Lewandowski RJ, Gabr A, Abouchaleh N, Ali R, Al Asadi A, Mora RA et al (2018) Radiation segmentectomy: potential curative therapy for early hepatocellular carcinoma. Radiology 287:1050–1058

  33. 33.

    Saini A, Wallace A, Alzubaidi S, Knuttinen MG, Naidu S, Sheth R et al (2019) History and evolution of yttrium-90 radioembolization for hepatocellular carcinoma. J Clin Med. https://doi.org/10.3390/jcm8010055

  34. 34.

    Kudo M (2018) Proposal of primary endpoints for TACE combination trials with systemic therapy: lessons learned from 5 negative trials and the positive TACTICS trial. Liver Cancer 7:225–234

  35. 35.

    Kim JH, Won HJ, Shin YM, Kim KA, Kim PN (2011) Radiofrequency ablation for the treatment of primary intrahepatic cholangiocarcinoma. AJR Am J Roentgenol 196:W205–W209

  36. 36.

    Fu Y, Yang W, Wu W, Yan K, Xing BC, Chen M‑H (2012) Radiofrequency ablation in the management of unresectable intrahepatic cholangiocarcinoma. J Vasc Interv Radiol 23:642–649

  37. 37.

    Tan W, Deng Q, Lin S, Wang Y, Xu G (2019) Comparison of microwave ablation and radiofrequency ablation for hepatocellular carcinoma: a systematic review and meta-analysis. Int J Hyperthermia 36:264–272

  38. 38.

    Koch C, Franzke C, Bechstein WO, Schnitzbauer AA, Filmann N, Vogl T et al (2019) Poor prognosis of advanced cholangiocarcinoma: real-world data from a tertiary referral center. Digestion. https://doi.org/10.1159/000500894

  39. 39.

    Ray CE, Edwards A, Smith MT, Leong S, Kondo K, Gipson M et al (2013) Metaanalysis of survival, complications, and imaging response following chemotherapy-based transarterial therapy in patients with unresectable intrahepatic cholangiocarcinoma. J Vasc Interv Radiol 24:1218–1226

  40. 40.

    Boehm LM, Jayakrishnan TT, Miura JT, Zacharias AJ, Johnston FM, Turaga KK et al (2015) Comparative effectiveness of hepatic artery based therapies for unresectable intrahepatic cholangiocarcinoma. J Surg Oncol 111:213–220

Download references

Author information

Correspondence to PD Dr. med. J. B. Hinrichs.

Ethics declarations

Interessenkonflikt

J.B. Hinrichs und F.K. Wacker geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Redaktion

M. Manns, Hannover

T. Wirth, Hannover

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Hinrichs, J.B., Wacker, F.K. Lokoregionäre und lokal ablative Therapien von Lebertumoren. Internist (2020) doi:10.1007/s00108-019-00725-8

Download citation

Schlüsselwörter

  • Interventionelle Radiologie
  • Interventionelle Onkologie
  • Radiofrequenzablation
  • Therapeutische Embolisation
  • Minimal-invasive Operationsverfahren

Keywords

  • Interventional radiology
  • Interventional oncology
  • Radiofrequency ablation
  • Embolization, therapeutic
  • Minimally invasive surgical procedures