Thermal ablation of intrahepatic cholangiocarcinoma

Safety, efficacy, and factors affecting local tumor progression

Edwin A. Takahashi, Kristin A. Kinsman, Grant D. Schmit, Thomas D. Atwell, John J. Schmitz, Brian T. Welch, Matthew R Callstrom, Jennifer R. Geske, A. Nicholas Kurup

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: To evaluate the safety and oncologic efficacy of percutaneous thermal ablation of intrahepatic cholangiocarcinoma (ICC) and identify risk factors for local tumor progression (LTP). Materials and methods: Retrospective review of an institutional tumor ablation registry demonstrated that 20 patients (9 males, 11 females; mean age 62.5 ± 15.8 years) with 50 ICCs (mean size 1.8 ± 1.3 cm) were treated with percutaneous radiofrequency ablation (RFA) or microwave ablation (MWA) between 2006 and 2015. Thirty-eight of the treated ICCs (76%) were metastases that developed after surgical resection of the primary tumor. Patient demographics, procedure technical parameters, and clinical outcomes were reviewed. A Cox proportional hazards model was used to examine the risk of LTP by ablation modality. Survival analyses were performed using the Kaplan–Meier method. Results: Mean imaging follow-up time was 41.5 ± 42.7 months. Forty-four (88%) ICCs were treated with RFA, and 6 (12%) with MWA. Eleven (22%) cases of LTP developed in 5 (25%) patients. The median time to LTP among these 11 tumors was 7.1 months (range, 2.3–22.9 months). Risk of LTP was not significantly different for ICCs treated with MWA compared to RFA (HR 2.72; 95% CI 0.58–12.84; p = 03.21). Median disease-free survival was 8.2 months (1.1–70.4 months), and median overall survival was 23.6 months (7.4–122.5 months). No major complication occurred. Conclusions: Percutaneous thermal ablation is a safe and effective treatment for patients with ICCs and may be particularly valuable in unresectable patients, or those who have already undergone hepatic surgery. Tumor size and ablation modality were not associated with LTP, whereas primary tumors and superficially located tumors were more likely to subsequently recur.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Jun 4 2018

Fingerprint

Cholangiocarcinoma
Hot Temperature
Safety
Neoplasms
Microwaves
Survival Analysis
Proportional Hazards Models
Disease-Free Survival
Registries
Demography

Keywords

  • Cholangiocarcinoma
  • CT
  • Microwave ablation
  • Radiofrequency ablation

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

Takahashi, E. A., Kinsman, K. A., Schmit, G. D., Atwell, T. D., Schmitz, J. J., Welch, B. T., ... Kurup, A. N. (Accepted/In press). Thermal ablation of intrahepatic cholangiocarcinoma: Safety, efficacy, and factors affecting local tumor progression. Abdominal Radiology, 1-6. https://doi.org/10.1007/s00261-018-1656-3

Thermal ablation of intrahepatic cholangiocarcinoma : Safety, efficacy, and factors affecting local tumor progression. / Takahashi, Edwin A.; Kinsman, Kristin A.; Schmit, Grant D.; Atwell, Thomas D.; Schmitz, John J.; Welch, Brian T.; Callstrom, Matthew R; Geske, Jennifer R.; Kurup, A. Nicholas.

In: Abdominal Radiology, 04.06.2018, p. 1-6.

Research output: Contribution to journalArticle

Takahashi, Edwin A. ; Kinsman, Kristin A. ; Schmit, Grant D. ; Atwell, Thomas D. ; Schmitz, John J. ; Welch, Brian T. ; Callstrom, Matthew R ; Geske, Jennifer R. ; Kurup, A. Nicholas. / Thermal ablation of intrahepatic cholangiocarcinoma : Safety, efficacy, and factors affecting local tumor progression. In: Abdominal Radiology. 2018 ; pp. 1-6.
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abstract = "Purpose: To evaluate the safety and oncologic efficacy of percutaneous thermal ablation of intrahepatic cholangiocarcinoma (ICC) and identify risk factors for local tumor progression (LTP). Materials and methods: Retrospective review of an institutional tumor ablation registry demonstrated that 20 patients (9 males, 11 females; mean age 62.5 ± 15.8 years) with 50 ICCs (mean size 1.8 ± 1.3 cm) were treated with percutaneous radiofrequency ablation (RFA) or microwave ablation (MWA) between 2006 and 2015. Thirty-eight of the treated ICCs (76{\%}) were metastases that developed after surgical resection of the primary tumor. Patient demographics, procedure technical parameters, and clinical outcomes were reviewed. A Cox proportional hazards model was used to examine the risk of LTP by ablation modality. Survival analyses were performed using the Kaplan–Meier method. Results: Mean imaging follow-up time was 41.5 ± 42.7 months. Forty-four (88{\%}) ICCs were treated with RFA, and 6 (12{\%}) with MWA. Eleven (22{\%}) cases of LTP developed in 5 (25{\%}) patients. The median time to LTP among these 11 tumors was 7.1 months (range, 2.3–22.9 months). Risk of LTP was not significantly different for ICCs treated with MWA compared to RFA (HR 2.72; 95{\%} CI 0.58–12.84; p = 03.21). Median disease-free survival was 8.2 months (1.1–70.4 months), and median overall survival was 23.6 months (7.4–122.5 months). No major complication occurred. Conclusions: Percutaneous thermal ablation is a safe and effective treatment for patients with ICCs and may be particularly valuable in unresectable patients, or those who have already undergone hepatic surgery. Tumor size and ablation modality were not associated with LTP, whereas primary tumors and superficially located tumors were more likely to subsequently recur.",
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AU - Atwell, Thomas D.

AU - Schmitz, John J.

AU - Welch, Brian T.

AU - Callstrom, Matthew R

AU - Geske, Jennifer R.

AU - Kurup, A. Nicholas

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N2 - Purpose: To evaluate the safety and oncologic efficacy of percutaneous thermal ablation of intrahepatic cholangiocarcinoma (ICC) and identify risk factors for local tumor progression (LTP). Materials and methods: Retrospective review of an institutional tumor ablation registry demonstrated that 20 patients (9 males, 11 females; mean age 62.5 ± 15.8 years) with 50 ICCs (mean size 1.8 ± 1.3 cm) were treated with percutaneous radiofrequency ablation (RFA) or microwave ablation (MWA) between 2006 and 2015. Thirty-eight of the treated ICCs (76%) were metastases that developed after surgical resection of the primary tumor. Patient demographics, procedure technical parameters, and clinical outcomes were reviewed. A Cox proportional hazards model was used to examine the risk of LTP by ablation modality. Survival analyses were performed using the Kaplan–Meier method. Results: Mean imaging follow-up time was 41.5 ± 42.7 months. Forty-four (88%) ICCs were treated with RFA, and 6 (12%) with MWA. Eleven (22%) cases of LTP developed in 5 (25%) patients. The median time to LTP among these 11 tumors was 7.1 months (range, 2.3–22.9 months). Risk of LTP was not significantly different for ICCs treated with MWA compared to RFA (HR 2.72; 95% CI 0.58–12.84; p = 03.21). Median disease-free survival was 8.2 months (1.1–70.4 months), and median overall survival was 23.6 months (7.4–122.5 months). No major complication occurred. Conclusions: Percutaneous thermal ablation is a safe and effective treatment for patients with ICCs and may be particularly valuable in unresectable patients, or those who have already undergone hepatic surgery. Tumor size and ablation modality were not associated with LTP, whereas primary tumors and superficially located tumors were more likely to subsequently recur.

AB - Purpose: To evaluate the safety and oncologic efficacy of percutaneous thermal ablation of intrahepatic cholangiocarcinoma (ICC) and identify risk factors for local tumor progression (LTP). Materials and methods: Retrospective review of an institutional tumor ablation registry demonstrated that 20 patients (9 males, 11 females; mean age 62.5 ± 15.8 years) with 50 ICCs (mean size 1.8 ± 1.3 cm) were treated with percutaneous radiofrequency ablation (RFA) or microwave ablation (MWA) between 2006 and 2015. Thirty-eight of the treated ICCs (76%) were metastases that developed after surgical resection of the primary tumor. Patient demographics, procedure technical parameters, and clinical outcomes were reviewed. A Cox proportional hazards model was used to examine the risk of LTP by ablation modality. Survival analyses were performed using the Kaplan–Meier method. Results: Mean imaging follow-up time was 41.5 ± 42.7 months. Forty-four (88%) ICCs were treated with RFA, and 6 (12%) with MWA. Eleven (22%) cases of LTP developed in 5 (25%) patients. The median time to LTP among these 11 tumors was 7.1 months (range, 2.3–22.9 months). Risk of LTP was not significantly different for ICCs treated with MWA compared to RFA (HR 2.72; 95% CI 0.58–12.84; p = 03.21). Median disease-free survival was 8.2 months (1.1–70.4 months), and median overall survival was 23.6 months (7.4–122.5 months). No major complication occurred. Conclusions: Percutaneous thermal ablation is a safe and effective treatment for patients with ICCs and may be particularly valuable in unresectable patients, or those who have already undergone hepatic surgery. Tumor size and ablation modality were not associated with LTP, whereas primary tumors and superficially located tumors were more likely to subsequently recur.

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KW - CT

KW - Microwave ablation

KW - Radiofrequency ablation

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