Safety and Efficacy of Percutaneous Thermal Ablation of Juxta-Cardiac Hepatic Tumours

  • Justin Kwan
  • Chinthaka Appuhamy
  • Gavin Hock Tai Lim
  • Ivan Kuang Hsin Huang
  • Lawrence Quek
  • Uei Pua
Clinical Investigation
  • 25 Downloads

Abstract

Introduction

To evaluate the safety and efficacy of percutaneous thermal ablation of liver tumours in a juxta-cardiac (JC) location.

Materials and Methods

From January 2010 to December 2014, out of 274 cases of hepatic ablation, 33 consecutive patients who received thermal ablation (radiofrequency or microwave) to left hepatic lobe tumours were included in this study. Patients were divided into two groups: JC or non-juxta-cardiac (NJC) (tumour margin ≤ 10 mm or > 10 mm from the cardiac border, respectively). Imaging follow-up was performed at 6-week and 3-monthly intervals. Technical success, 30-day complications and local tumour control/recurrence were recorded. Statistical analysis was performed with t test and Fisher’s test. Univariate and multivariate survival analyses were performed using Cox regression.

Results

Patients comprised of 23 men and 10 women (mean age 67.0 years). Mean tumour size was 2.2 ± 0.9 cm (28 hepatocellular carcinoma and 5 metastases). Mean follow-up time was 21.2 months (range 2–72 months). There were no differences between the JC and NJC groups in the rates of complete ablation (86.7 vs 83.3% P = 1.0), tumour recurrence (20.0 vs 22.2%, P = 0.95) or complication rates (6.7 vs 11.1% P = 1.0). Metastatic lesions were associated with a higher rate of recurrent disease (hazard ratio 3.86, 95% CI 1.0–14.8%, P = 0.05).

Discussion

Percutaneous thermal ablation of JC tumours has similar rates of local tumour control and safety profile when compared to tumours in a NJC location. Tumours in a JC location should not be considered a contraindication for thermal ablation.

Keywords

Hepatic tumour Juxta-cardiac Thermal ablation 

Notes

Acknowledgements

We would like to thank Ms. Sun Bing Fan for helping with the statistical analysis of the results within this article.

Compliance with Ethical Standards

Conflict of interest

All the authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Supplementary material

270_2018_1938_MOESM1_ESM.mov (1.7 mb)
Video 1 Sagittal oblique ultrasound cine clip taken during immediately after the ablation procedure of the same patient, demonstrating the extent of the gas cloud extending to the cardiac margin interface (MOV 1720 kb)

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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

  1. 1.Department of Diagnostic and Interventional RadiologyTan Tock Seng HospitalSingaporeSingapore
  2. 2.Neurotrauma CentreNational Hospital of Sri LankaColomboSri Lanka

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