Radiofrequency Ablation for the Treatment of Primary Intrahepatic Cholangiocarcinoma

被引:143
作者
Kim, Jin Hyoung [1 ,2 ]
Won, Hyung Jin [1 ,2 ]
Shin, Yong Moon [1 ,2 ]
Kim, Kyung-Ah [1 ,2 ]
Kim, Pyo Nyun [1 ,2 ]
机构
[1] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul, South Korea
[2] Univ Ulsan, Coll Med, Asan Med Ctr, Res Inst Radiol, Seoul, South Korea
关键词
CT; hepatectomy; intrahepatic cholangiocarcinoma; radiofrequency ablation; TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION; UNRESECTABLE CHOLANGIOCARCINOMA; PROGNOSTIC-FACTORS; HEPATOCELLULAR-CARCINOMA; SINGLE-INSTITUTION; LIVER METASTASES; LONG-TERM; MALIGNANCIES; SURVIVAL; RADIOTHERAPY;
D O I
10.2214/AJR.10.4937
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
OBJECTIVE. We present the results of percutaneous radiofrequency ablation (RFA) in patients with unresectable primary intrahepatic cholangiocarcinoma. MATERIALS AND METHODS. From 2000 to 2009, 13 patients with 17 primary intrahepatic cholangiocarcinomas underwent RFA at our institution. Intrahepatic cholangiocarcinoma was unresectable because of poor hepatic reserve due to liver cirrhosis in nine patients, extrahepatic extension in two, atrophy of the left hepatic lobe in one, and underlying comorbidities in one. Ten tumors had a diameter of less than 3 cm, five were between 3 and 5 cm, and two were larger than 5 cm. Technical effectiveness was defined as the complete ablation of the tumor, shown by imaging follow-up 1 month later. Local progression-free survival, overall survival periods, and complications after RFA were also evaluated. RESULTS. Technical effectiveness of RFA was achieved for 15 of the 17 tumors (88%), all smaller than 5 cm in diameter. Treatment failure occurred in two patients with large tumors (7 and 8 cm). After the 17 RFA sessions, one major complication (6%), a liver abscess, occurred 1 month later. During follow-up (median, 19.5 months; range, 3.3-82.1 months), nine patients died and four remain alive. Median local progression-free survival and overall survival periods were 32.2 and 38.5 months, respectively. The 1-, 3-, and 5-year survival rates were 85%, 51%, and 15%, respectively. CONCLUSION. RFA may provide successful local tumor control in patients with primary intrahepatic cholangiocarcinomas of intermediate (3-5 cm) or small (< 3 cm) diameter. RFA for unresectable primary intrahepatic cholangiocarcinoma resulted in a median overall survival period of 38.5 months.
引用
收藏
页码:W205 / W209
页数:5
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