Combination of simultaneous radiofrequency and chemical ablation for malignant liver tumors
O.I. ZHAVORONKOVA, D.A. IONKIN, Ya.Ya. GAVRILOV, V.A. VISHNEVSKIY
Institute for Surgery named after A.V. Vishnevskiy, 27 Bolshaya Serpukhovskaya Str., Moscow, Russian Federation, 117997
Zhavoronkova O.I. ― Cand. Med. Sc., Senior Researcher of the Department of Ultrasound Diagnostics, tel. +7-910)-453-95-45, e-mail: Shavoronkova@ixv.ru
Ionkin D.A. ― Cand. Med. Sc., Senior Researcher of the Department of Surgical Hepatology and Pancreatology, tel. +7-916-863-45-34, e-mail: ionkin@ixv.comcor.ru
Gavrilov Ya.Ya. ― doctor of the Department of Ultrasound Diagnostics, tel. +7-925-033-70-74, e-mail: jngavrilov@mail.ru
Visnevskiy V.A. ― D. Med. Sc., Professor, Head of the Department of Abdominal Surgery №2, tel. (499) 237-80-54, e-mail: VishnevskyVA@ixv.ru
The article presents an analysis of a combination of radiofrequency ablation and introduction of 95% ethanol to patients with primary and metastatic cancer of the liver. The indications and contra-indications for this combination are identified. The immediate and remote results of the operation are described. The role of post-operative protocol is emphasized.
Key words: malignant tumors of the liver, metastatic cancer of the liver, hepatocellular carcinoma, radiofrequency ablation, RFA, percutaneous introduction of ethanol.
REFERENCES
- Kaprin A.D., Starinskiy V.V. Zlokachestvennye novoobrazovaniya v Rossii v 2012 godu [Malignancies in Russia in 2012], 2014. Pp. 4-250.
- Parkin D.M., Bray F., Ferlay J. et al. Global cancer statistic, 2002. CA Cancer J. Clin, 2005, vol. 55, pp. 74-108.
- Page A., Cosgrove D., Herman J. et al. Advances in understanding of colorectal liver metastasis and implications for the clinic. Expert Rev. Gastroenterol. Hepatol. Early online, 1–15 (2014).
- Ungureanu B., Săndulescu L., Șurlin V. et al. Surgical hepatic resection vs. ultrasonographic guided radiofrequency ablation in colorectal liver metastases: what should we choose. Med. Ultrason, 2014, vol. 16, no. 2, pp. 145-151.
- Abdalla E.K., Hicks M.E., Vauthey J.N. Portal vein embolization: rationale, technique and future prospects. Br. J. Surg, 2001, no. 88, pp. 165-175.
- Doci R., Gennari L., Bignami P. et al. Morbidity and mortality after hepatic resection of metastases from colorectal cancer. Br. J. Surg, 1995, vol. 82, pp. 377-381.
- Matsumata T., Taketomi A., Kawahara N. et al. Morbidity and mortality after hepatic resection in the modern era. Hepatogastroenterology, 1995, vol. 42, pp. 456-460.
- Adam R., Laurent A., Azoulay D. et al. Two-stage hepatectomy: a planned strategy to treat irresectable liver tumors. Ann. Surg, 2000, vol. 232, pp. 777-785.
- Lencioni R., Crocetti L., Cioni D. et al. Percutaneous radiofrequency ablation of hepatic colorectal metastases: technique, indications, results, and new promises. Invest. Radiol, 2004, vol. 39, pp. 689-697.
- Efanov M.G. Segmentarnye rezektsii pri ochagovykh obrazovaniyakh pecheni: avtoref. dis. … dokt. med. nauk [Segmental resection of focal lesions of the liver. Synopsis of dis. Dr med. scinces]. Moscow, 2010. 52 p.
- Peterson B.E. Khirurgicheskoe lechenie zlokachestvennykh opukholey [Surgical treatment of malignant tumors]. Moscow: Meditsina, 1981. No. 2. Pp. 42-44.
- Tkachev M.V. Monitoring results of radiofrequency thermoablation colorectal liver metastases using tumor markers. Aspirantskiy vestnik Povolzh’ya, 2014, no. 5-6, pp. 112-115 (in Russ.).
- Weng M., Zhang Y., Zhou D., et al. Radiofrequency ablation versus resection for colorectal cancer liver metastases: a meta-analysis. PLoS One, 2012, 7, pp. e45493.
- Huang G., Chen X., Lau W.Y. Quality of life after surgical resection compared with radiofrequency ablation for small hepatocellular carcinomas. BJS Society Ltd, 2014, 101, pp. 1006-1015.
- Zakharchenko A.A., Kochetova L.V. Variany kombinirovannogo lecheniya bol’nykh s metastazami kolorektal’nogo raka v pechen’. Kazanskiy meditsinskiy zhurnal, 2009, vol. 90, no. 2, pp. 251-254 (in Russ.).
- Shankar S., van Sonnenberg E., Morrison P.R., et al. Combined radiofrequency and alcohol injection for percutaneous hepatic tumor ablation. AJR, 2004, 183, pp. 1425-1429 [Abstract].
- Vallone R., Catalano O., Izzo F., Siani F. Combined Ethanol Injection Therapy and Radiofrequency Ablation Therapy in Percutaneous Treatment of Hepatocellular Carcinoma Larger than 4 cm. CardioVascular and Interventional Radiology, August, 2006, vol. 29, issue 4, pp. 544-551.
- Kurokohchi K., Watanabe S., Masaki T., et al. Combination therapy of percutaneous ethanol injection and radiofrequency ablation against hepatocellular carcinomas difficult to treat. Int. J. Oncol, 2002, 21, pp. 611-615 [Medline].
- Kurokohchi K., Watanabe S., Masaki T., et al. Combined use of percutaneous ethanol injection and radiofrequency ablation for the effective treatment of hepatocellular carcinoma. Int. J. Oncol, 2002, 21, pp. 841-846 [Medline].
- Islam M.N., Saha M.M., Ahsan M. Percutaneous ethanol injection for ablation of hepatocellular carcinoma. Bang Med. J. (Khulna), 2010, vol. 43, pp. 12-17.
- Liu L.X., Zhang W.H, Jiang H.C. Current treatment for liver metastases from colorectal cancer. World J. Gastroenterol, 2003, vol. 9, pp. 193-200.
- Egorenkov V.V. Treatment of malignant liver tumors using local methods of destruction (chemical ablation, radiofrequency ablation, cryoablation). Prakticheskaya onkologiya, 2008, vol. 9, no. 4, pp. 202-208 (in Russ.).
- Elgindy N., Lindholm H., Gunvén P. Highdose percutaneous ethanol injection therapy of liver tumors: Patient acceptance and complications. Acta Radiologica, 2000, vol. 41, no. 5, pp. 458-46.
- Lencioni R., Caramella D., Sanguinetti F. et al. Portal vein thrombosis after percutaneous ethanol injection for hepatocellular carcinoma: Value of color Doppler sonography in distinguishing chemical and tumor thrombi. AJR, 1995, vol. 164, pp. 1125-1130.
- Veryasova N.N., Polysalov V.N., Ivanova A.A. et al. Lechenie zlokachestvennykh opukholey pecheni s primeneniem lokal’noy in»ektsionnoy terapii etanolom [Treatment of malignant liver tumors using local injection therapy ethanol]. TsNIIRI. SPb. Avtoreferat, 2002. 84 p.
- Elgindy N., Lindholm H., Gunvén P. Highse percutaneous ethanol injection therapy of liver tumors: Patient acceptance and complications. Acta Radiologica, 2000, vol. 41, no. 5, pp. 458-463.
- Simonov N.N. Surgical treatment of colorectal cancer in the presence of distant metastases. Cytoreductive, palliative, symptomatic operation. Prakticheskaya onkologiya, 2002, vol. 3, no. 2, pp. 130-136 (in Russ.).
- Siperstein A.E., Berber E. Cryoablation, Percutaneous Alcohol Injection, and Radiofrequency Ablation for Treatment of Neuroendocrine Liver Metastases. World. J. Surg, 2001, vol. 25, pp. 693-696.
- Kotoh K., Sakai H., Sakamoto S. et al. The effect of percutaneous ethanol injection therapy on small solitary hepatocellular carcinoma is comparable to that of hepatectomy. Am. J. Gastroenerol, 1994, vol. 89, pp. 194-198.
- Livraghi T. et al. Long term results of single session percutaneous ethanol injection in patients with large hepatocellular carcinoma. Cancer, 1998, vol. 83, pp. 48-57.
- Buscarini E., Buscarini L. Radiofrequency thermal ablation with expandable needle of focal liver malignancies: complication report. Eur. Radiol, 2004, vol. 14, pp. 31-37.
- Livraghi T. et al. Treatment of Focal Liver Tumors with Percutaneous Radiofrequency Ablation: Complications Encountered in a Multicenter Study. Radiology, 2003, vol. 226, rr. 441-451.
- McGahan J.P., Browning P.D., Brock J.M. Hepatic ablation using radiofrequency electrocautery. Invest Radiol, 1990, vol. 25, pp. 267-270.
- Solbiati L., Goldberg S.N., Ierace T. et al. Hepatic metastases: percutaneous radio-frequency ablation with cooled-tip electrodes. Radiology, 1997, vol. 205, pp. 367-373.
- Ionkin D.A., Vishnevskiy V.A., Chzhao A.V. The history of the radiofrequency ablation procedure hirugicheskoy. Vysokotekhnologichnaya meditsina, 2014, no. 2, pp. 4-11 (in Russ.).
- Weng M., Zhang Y., Zhou D., et al. Radiofrequency Ablation versus Resection for Colorectal Cancer Liver Metastases: A Meta-Analysis. PLoS ONE, 2012, 7 (9), pp. e45493. doi:10.1371/journal.pone.0045493 September 21, 2012.
- Stoltz A., Gagnière J., Dupré A. Radiofrequency ablation for colorectal liver metastases. Journal of Visceral Surgery, 2014, 151, pp. S33-S44.
- Lencioni R., Crocetti L., Cioni D. et al. Percutaneous radiofrequency ablation of hepatic colorectal metastases: technique, indications, results, and new promises. Invest. Radiol, 2004, 39 (11), pp. 689-697.
- Kosyrev, V.Yu., Dolgushin B.I. Features of radiofrequency thermal ablation of malignant liver tumors. Literature review. Meditsinskaya vizualizatsiya, 2011, 3, pp. 24-37 (in Russ.).
- Kosyrev V.Yu., Dolgushin B.I. Radiofrequency thermal ablation in the treatment of patients with hepatocellular carcinoma and metastatic colorectal cancer in the liver. Literature review. Meditsinskaya radiologiya i radiatsionnaya bezopasnost’, 2011, 2, pp. 68-81 (in Russ.).
- Vishnevskiy V.A., Ionkin D.A., Efanov M.G. et al. Radiofrequency thermal ablation of liver malignant tumors. Moskovskiy khirurgicheskiy zhurnal, 2008, 3, pp. 28-37 (in Russ.).
- Bleicher R.J., Allegra D.P., Nora D.T. et al. Radiofrequency ablation in 447 complex unresectable liver tumors: ltssons learned. Ann. Surg. Oncol, 2003, 10 (1), pp. 52-58.
- Solbiati L., Ierace T., Tonolini M., et al. Long-term survival of patients treated with radiofrequency ablation for liver colorectal metastases: improved outcome with increasing experience. Radiology, 2003, 229 (P), pp. 411-416.
- Li1 D., Kang J., Madoff D. Locally ablative therapies for primary and metastatic liver cancer. Expert Rev. Anticancer Ther, 2014, 14 (8), pp. 931-945
- Goldberg S.N., Gazelle G.S., Compton C.C. et al. Treatment of intrahepatic malignancy with radiofrequency ablation: radiologic — pathologic correlation. Cancer, 2007, no. 88, pp. 2452-2463.
- Lencioni R., Crocetti L., Cioni R. et al. Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicentre clinical trial (the RAPTURE study). Lancet Oncol, 2008, vol. 7, no. 9, pp. 621-628.
- Seror O. Large, N’Kontchou G., Ibraheem M. et al. (>or=5.0-cm) HCCs: multipolar RF ablation with three internally cooled bipolar electrodes-initial experience in 26 patients. Radiology, 2008, no. 248, pp. 288-296.
- Vishnevskiy V.A., Gavrilin A.V., Sergeeva O.N. Ionkin D.A. Radiofrequency ablation in the treatment of focal liver formations. Annaly khirurgicheskoy gepatologiii, 2004, 9 (2), pp. 77-79 (in Russ.).
- Petrenko K.N., Polishchuk L.O., Garmaeva S.V., Skipenko O.G. Radiofrequency ablation of malignant liver tumors. The current state of the issue (Literature Review). Rossiyskiy zhurnal gastroenterologii, gepatologii i koloproktologii, 2007, 2, pp. 10-17 (in Russ.).
- Kaganov O.I. Kombinirovannoe lechenie metastazov kolorektal’nogo raka v pecheni i legkikh s primeneniem radiochastotnoy ablatsii: avtoref. dis. … d-ra med. nauk [Combined treatment of colorectal cancer metastases in the liver and lungs with radiofrequency ablation. Synopsis of dis. Dr med. sciences]. Moscow, 2013. Pp. 37-45.
- Gillams A.R., Lees W.R. CT mapping of the distribution of saline during radiofrequency ablation with perfusion electrodes. Cardiovasc. Intervent. Radiol, 2005, Jul-Aug, 28 (4), pp. 476-480.
- Curley S.A. Radiofrequency ablation versus resection for resectable colorectal liver metastases: time for a randomized trial? Ann. Surg. Oncol, 2008, vol. 1, no. 15, pp. 11-13.
- Ostroverkhov G.E., Bomash Yu.M., Lubotskiy D.N. Operativnaya khirurgiya i topograficheskaya anatomiya [Operative surgery and topographic anatomy]. Kursk: AL “Kursk”, Moscow: AOZT. “Litera”, 1995. 720 p.
- Valls S., Ramos E., Leiva D. et al. Safety and Efficacy Of Ultrasound-Guided Radiofrequency Ablation Of Recurrent Colorectal Cancer Liver Metastases After Hepatectomy. Scandinavian Journal of Surgery, 2014, 0, 1-7.
- Ionkin D.A., Vishnevskiy V.A., Zhavoronkova O.I. et al. Radiofrequency ablation of colorectal cancer metastatic to the liver. Vysokotekhnologichnaya meditsina, 2014, no. 2, pp. 17-37 (in Russ.).


