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CardioVascular and Interventional Radiology

, Volume 42, Issue 1, pp 41–47 | Cite as

Reiterative Radiofrequency Ablation in the Management of Pediatric Patients with Hepatoblastoma Metastases to the Lung, Liver, or Bone

  • Steven Yevich
  • Marco Calandri
  • Guillaume Gravel
  • Brice Fresneau
  • Laurence Brugières
  • Dominique Valteau-Couanet
  • Sophie Branchereau
  • Christophe Chardot
  • Isabelle Aerts
  • Thierry de Baere
  • Lambros Tselikas
  • Frederic Deschamps
Clinical Investigation Interventional Oncology
Part of the following topical collections:
  1. Interventional Oncology

Abstract

Background and Purpose

Conventional treatments of systemic chemotherapy and surgical resection for recurrent or metastatic hepatoblastoma (HB) may be inhibitive for the pediatric patient and family who have already been through extensive therapies. This single-institution case series evaluates the safety and efficacy of percutaneous radiofrequency ablation (RFA) in the management of metastatic HB.

Materials and Methods

Between March 2008 and February 2015, RFA was used as part of multidisciplinary management for HB recurrence or metastasis in 5 children (median 5.0 years old) in an attempt to provide locoregional control and preclude additional surgery. Combined local treatments of 38 metachronous metastases included surgical metastasectomy (14 lesions: 7 lung, 7 liver), percutaneous RFA (23 lesions: 21 lung, 1 liver, 1 bone), and stereotactic radiotherapy (1 liver lesion).

Results

For lesions treated with RFA (median diameter 6 mm, range 3–15 mm), local control was achieved in 22/23 metastases (95.6%) with median follow-up of 30.1 months after RFA (range 18.9–65.7). Median hospitalization was 3 days (2–7), with major complications limited to 1 pneumothorax requiring temporary small-caliber chest tube. Four children remain in complete remission with median follow-up of 67 months (range 41.2–88.8) after primary tumor resection, with mean disease-free survival of 31.7 months after last local treatment. One child succumbed to rapidly progressive disease 12 months after RFA (23.9 months after primary tumor resection).

Conclusion

RFA provides a safe and effective reiterative treatment option in the multidisciplinary management of children with metastatic HB.

Keywords

Hepatoblastoma Pediatric Radiofrequency Ablation Metastasis 

Abbreviations

HB

Hepatoblastoma

RFA

Radiofrequency ablation

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  • Steven Yevich
    • 1
  • Marco Calandri
    • 1
  • Guillaume Gravel
    • 1
  • Brice Fresneau
    • 2
  • Laurence Brugières
    • 2
  • Dominique Valteau-Couanet
    • 2
  • Sophie Branchereau
    • 3
  • Christophe Chardot
    • 4
  • Isabelle Aerts
    • 5
  • Thierry de Baere
    • 1
  • Lambros Tselikas
    • 1
  • Frederic Deschamps
    • 1
  1. 1.Interventional Radiology DepartmentGustave RoussyVillejuifFrance
  2. 2.Pediatric and Teenage Oncology DepartmentGustave RoussyVillejuifFrance
  3. 3.Pediatric Surgery DepartmentHospital du Kremlin BicêtreVillejuifFrance
  4. 4.Pediatric Surgery DepartmentHospital Necker enfants maladesParisFrance
  5. 5.Pediatric and Teenage Oncology DepartmentInstitut CurieParisFrance

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