Journal
CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY
Volume 35, Issue 6, Pages 1372-1379Publisher
SPRINGER
DOI: 10.1007/s00270-012-0341-0
Keywords
Embolization; Liver metastases; Radiofrequency
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This retrospective study evaluated the feasibility, efficacy, and safety of combining transcatheter arterial embolization (TAE) with radiofrequency thermal ablation (RFA) in a single session for the treatment of technically unresectable liver-only malignancies. From May 2006 to January 2011, a total of 30 patients affected by liver metastases with single or multiple unresectable liver-only lesions underwent a combined treatment with TAE followed by RFA in the same session, for a total of 36 treated lesions. Patients were extrapolated from a cohort of patients discussed within the weekly institutional tumor board. TAE was performed by using 100 mu m microspheres; RFA was performed immediately after TAE by positioning the electrode needle via ultrasound and/or computed tomographic guidance. Local tumor responses and procedure-related complications were evaluated. Completion of both procedures was obtained in all patients for all 36 lesions. Liver lesions had a maximum axial diameter ranging 16-59 mm. Postintervention unenhanced ablated areas ranged 28-104 mm in maximum axial diameter. Safety margins ranged 1-30.5 mm. Complete response, defined as complete devascularization at computed tomography, was obtained in all treated lesions for a maximum period of 12 months. Tumor relapse was observed in one patient at 12 months. Sixteen patients developed new liver lesions or progressive systemic disease during follow-up. Nine patients were still disease-free. Seven patients died as a result of systemic progressive disease. One major treatment-related complication was observed. In patients with technically unresectable liver-only malignancies, single-session combined TAE-RFA is an effective and safe treatment.
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