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European Radiology

, Volume 29, Issue 2, pp 654–662 | Cite as

Percutaneous cryoablation for perivascular hepatocellular carcinoma: Therapeutic efficacy and vascular complications

  • Ran Kim
  • Tae Wook KangEmail author
  • Dong Ik Cha
  • Kyoung Doo Song
  • Min Woo Lee
  • Hyunchul Rhim
  • Hyo Keun Lim
  • Dong Hyun Sinn
Interventional
  • 168 Downloads

Abstract

Objectives

To evaluate the therapeutic efficacy of and vascular complications associated with percutaneous cryoablation for the treatment of perivascular HCC.

Methods

Between August 2015 and September 2017, 58 consecutive patients (48 men, 10 women; mean age, 61.1 years; age range, 44–84 years) who underwent percutaneous cryoablation were included. All patients had a single perivascular HCC (mean size, 1.3 cm; Barcelona clinic liver cancer-stage 0 or A) that was in contact with hepatic vessels, ≥ 3 mm or larger in axial diameter. Local tumour progression (LTP) was estimated by the Kaplan-Meier method. In addition, several procedure-related vascular complications were evaluated immediately after treatment and during follow-up CT: peritumoral vessel thrombosis; infarction; aggressive intrasegmental recurrence (AIR) (the simultaneous development of ≥ 3 nodular or infiltrative tumours). The follow-up CT was performed in all patients 1 month after the procedure, and every 3 months thereafter.

Results

The median follow-up period was 22 months (range, 3–29 months). The technical success rate of cryoablation was 96.6% (56/58). The 1- and 2-year cumulative LTP rates were 3.6% and 14.6%, respectively. Although peritumoral vessel thrombosis occurred in 6.9% of cases (4/58), no cases of hepatic infarction were observed and AIR did not develop during follow-up. Half of the thombi in the peritumoral vessels immediately after cryoablation disappeared on follow-up CT images.

Conclusion

Cryoablation could be an effective tool for the treatment of perivascular HCC with a very low risk of vascular complications.

Key Points

• Cryoablation allowed a high technical success rate for perivascular HCC.

• Only 6.9% developed peritumoral vessel thrombosis without major vascular complications like infarction.

• Two-year cumulative LTP rate was 14.6%, without aggressive tumour recurrence on follow-up.

Keywords

Liver Hepatocellular carcinoma Cryoablation Treatment outcome 

Abbreviations

BCLC

Barcelona clinic liver cancer-stage

CI

Confidence interval

CT

Computed tomography

HCC

Hepatocellular carcinoma

LTP

Local tumour progression

MR

Magnetic resonance

RF

Radiofrequency

TACE

Transarterial chemoembolisation

US

Ultrasound

Notes

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Won Jae Lee.

Conflict of interest

The authors of this paper declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Retrospective

• Observational

• Performed at one institution

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Ran Kim
    • 1
  • Tae Wook Kang
    • 1
    Email author
  • Dong Ik Cha
    • 1
  • Kyoung Doo Song
    • 1
  • Min Woo Lee
    • 1
  • Hyunchul Rhim
    • 1
  • Hyo Keun Lim
    • 1
    • 2
  • Dong Hyun Sinn
    • 3
  1. 1.Department of Radiology and Center for Imaging Science, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea
  2. 2.Department of Health Sciences and TechnologySAIHST, Sungkyunkwan University School of MedicineSeoulKorea
  3. 3.Department of Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea

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