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Microwave ablation for hepatocellular carcinoma associated with Budd–Chiari syndrome after transarterial chemoembolization: an analysis of ten cases

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Abstract

Purpose

To evaluate the feasibility, efficacy, and safety of microwave ablation (MWA) in the treatment of hepatocellular carcinoma associated with Budd–Chiari syndrome (BCS) after transarterial chemoembolization (TACE).

Methods

A total of 10 patients (mean 50.0 ± 7.5 years) with 15 BCS-associated HCC lesions were retrospectively evaluated. All patients received MWA treatment for residual tumors after 1 to 3 sessions of TACE. The diagnosis of residual tumors was confirmed by at least two types of enhanced imaging. CEUS images were performed to confirm the residual lesions and guide the placement of antenna before MWA. Thermal monitoring and artificial pleural effusion or ascites were used to guarantee ablative accuracy and safety for patients with tumors adjacent to vital structures. Technical success, technique efficacy, local tumor progression, survival rate, and the incidence of complications were comprehensively analyzed.

Results

Technical success and technique effectiveness were achieved in all patients. Thirteen lesions achieved complete ablation for the first time, and 2 lesions needed two sessions. Thermal monitoring was used in 2 patients, artificial pleural effusion was used in 1 patient, and artificial ascites in 2 patients. In a median follow-up of 34.5 months (range 21–52 months), no LTP was founded in all patients. Intrahepatic recurrence was found in 5 patients. 1-, 2-, 3-, and 4-year survival rates were 100%, 100%, 74.1%, and 37.0%, respectively. No major or minor complications were observed.

Conclusion

Microwave ablation is a feasible and effective way to treat residual tumors after TACE treatment in patients with BCS-associated HCC.

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Authors and Affiliations

  1. Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China

    Jian-Ping Dou, Jie Yu, Zhi-yu Han, Fang-yi Liu, Zhi-gang Cheng & Ping Liang

Authors
  1. Jian-Ping Dou
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  2. Jie Yu
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  3. Zhi-yu Han
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  4. Fang-yi Liu
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  5. Zhi-gang Cheng
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  6. Ping Liang
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Corresponding author

Correspondence to Ping Liang.

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Funding

This study was funded by National Key Technology Research and Development Program of China (2013BAI01B01) and National Natural Science Foundation of China (CN) (81430039).

Conflict of interest

Authors declare no conflict of interest.

Ethical approval

All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Dou, JP., Yu, J., Han, Zy. et al. Microwave ablation for hepatocellular carcinoma associated with Budd–Chiari syndrome after transarterial chemoembolization: an analysis of ten cases. Abdom Radiol 42, 962–968 (2017). https://doi.org/10.1007/s00261-016-0923-4

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  • DOI: https://doi.org/10.1007/s00261-016-0923-4

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