ABSTRACT
OBJECTIVE: This study was performed to determine the relationship between the minimum distance from the radiofrequency ablation (RFA) needle tip to the tumor and local tumor progression (LTP) of hepatocellular carcinoma (HCC) nodules and identify prognostic factors for LTP. METHODS: We reviewed 197 patients (197 nodules) who underwent RFA after transcatheter arterial chemoembolization for HCC from January 2010 to January 2015. Three-dimensional registration of images was used to calculate the minimum distance from the tip to the tumor. We then divided the minimum distance into two groups: <2 and ≥2 mm. Contrast-enhanced computed tomography was performed after treatment. The LTP rate was calculated 1 and 3 years after RFA. We performed multivariate analysis to identify independent prognostic factors for LTP. RESULTS: The cumulative 1-year LTP rates in the <2- and ≥2-mm groups were 82.7% and 4.3%, respectively, and the cumulative 3-year LTP rates in the two groups were 94.8% and 10.8%, respectively. The minimum distance from the needle tip to the tumor was an independent prognostic factor for LTP. CONCLUSIONS: A minimum distance of 2 mm from the needle tip to the tumor should be completely ablated along with the tumor.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Hepatocellular/pathology , Chemoembolization, Therapeutic/methods , Liver Neoplasms/pathology , Radiofrequency Ablation/methods , Carcinoma, Hepatocellular/therapy , Combined Modality Therapy , Disease Progression , Female , Follow-Up Studies , Humans , Liver Neoplasms/therapy , Male , Middle Aged , Needles , Retrospective Studies , Treatment OutcomeABSTRACT
OBJECTIVE: This study aimed to determine if superselective renal artery embolization is a safe and effective method of treating bleeding complications after percutaneous renal biopsy. METHODS: From January 2006 to December 2017, 43 patients (22 men and 21 women, mean age: 44.5 ± 14.0 years) underwent angiography for post-biopsy bleeding complications following percutaneous biopsy. Patients underwent angiography and superselective artery embolization. We recorded serum creatinine and hemoglobin values to assess the effect of embolization. RESULTS: Successful embolization was achieved in all patients. There was a pseudoaneurysm in 10 cases, arteriovenous fistula in eight, contrast media extravasation in 16, arteriovenous fistula combined with contrast media extravasation in five, and pseudoaneurysm combined with arteriovenous fistula in four. The embolic substance was a microcoil only or combined with a gelatin sponge. The mean creatinine value was not different at 1 day and 1 week after embolization compared with before embolization. Mean hemoglobin values were significantly higher at 1 day and 1 week after embolization than before embolization. CONCLUSIONS: Superselective renal artery embolization is a safe and effective treatment for post-biopsy bleeding complications after percutaneous renal biopsy. Lumbar or iliolumbar artery angiography is necessary if renal arteriography shows no signs of hemorrhage.
Subject(s)
Arteriovenous Fistula/etiology , Arteriovenous Fistula/therapy , Embolization, Therapeutic/methods , Nephrectomy/adverse effects , Postoperative Hemorrhage/etiology , Postoperative Hemorrhage/therapy , Renal Artery/injuries , Adolescent , Adult , Aged , Angiography , Arteriovenous Fistula/diagnostic imaging , Biopsy , Creatinine/blood , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Hemorrhage/diagnostic imaging , Prognosis , Renal Artery/surgery , Young AdultABSTRACT
Objective This study was performed to determine whether transarterial chemoembolization (TACE) plus multi-imaging-guided radiofrequency ablation (MIG-RFA) can completely eliminate 3.1- to 5.0-cm hepatocellular carcinoma (HCC) nodules and identify factors that may influence the complete elimination rate (CER) of this therapy. Methods Patients who underwent TACE+MIG-RFA for initial treatment of HCC from January 2008 to January 2016 were retrospectively reviewed. In total, 162 patients with 216 HCC nodules (3.1-5.0 cm) were enrolled. TACE was performed first; MIG-RFA was performed 2 to 4 weeks later. Contrast-enhanced computed tomography was performed 1, 3, 6, and 12 months after TACE+MIG-RFA. If tumor enhancement was not detected by the end of the 12-month follow-up, the lesion was considered completely eliminated. Additional TACE+MIG-RFA was performed for residual lesions. The CER was calculated 12 months after the last therapy. Factors that may influence the CER were analyzed. Results In total, 207 (95.8%) nodules showed no residual lesions and were completely eliminated after one or more TACE+MIG-RFA sessions. Nine (4.2%) nodules were incompletely eliminated even with repeated TACE+MIG-RFA. Tumor location was the only significant prognostic factor influencing the CER. Conclusions TACE+MIG-RFA can eliminate 3.1- to 5.0-cm HCC nodules; the tumor location may affect the treatment outcome.
