Abstract
Objective
Most recurrent intrahepatic cholangiocarcinoma (RICC) lost the opportunity of radical resection while most nonsurgical management failed to prolong patients’ survival. The efficacy and safety of radiofrequency ablation (RFA) as a local treatment for recurrent hepatocellular carcinoma have been confirmed by many clinical studies. The purpose of this study was to evaluate the efficacy, long-term survival and complications of RFA for RICC.
Methods
A total of 12 patients with 19 RICCs after radical resection were included in this study. The tumors were 1.9–6.8 cm at the maximum diameter (median, 3.2±1.6 cm). All patients were treated with ultrasound guided RFA. There were two RFA approaches including percutaneous and open.
Results
A total of 18 RFA treatment sessions were performed. Ablation was successful (evaluated by 1-month CT after the initial RFA procedure) in 18 (94.7%) of 19 tumors. By a median follow-up period of 29.9 months after RFA, 5 patients received repeated RFA because of intrahepatic lesion recurrence. The median local recurrence-free survival period and median event-free survival period after RFA were 21.0 months and 13.0 months, respectively. The median overall survival was 30 months, and the 1- and 3-year survival rates were 87.5% and 37.5%, respectively. The complication rate was 5.6% (1/18 sessions). The only one major complication was pleural effusion requiring thoracentesis.
Conclusion
This study showed RFA may effectively and safely manage RICC with 3-year survival of 37.5%. It provides a treatment option for these RICC patients who lost chance for surgery.
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Refernces
Nakajima T, Kondo Y, Miyazaki M, et al. A histopathologic study of 102 cases of intrahepatic cholangiocarcinoma: histologic classification and modes of spreading. Hum Pathol 1988; 19: 1228–1234.
Lim JH, Park CK. Pathology of cholangiocarcinoma. Abdom Imaging 2004; 29: 540–547.
Endo I, Gonen M, Yopp AC, et al. Intrahepatic cholangiocarcinoma: rising frequency, improved survival, and determinants of outcome after resection. Ann Surg 2008; 248: 84–96.
DeOliveira ML, Cunningham SC, Cameron JL, et al. Cholangio-carcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg 2007; 245: 755–762.
Konstadoulakis MM, Roayaie S, Gomatos IP, et al. Fifteen-year, single-center experience with the surgical management of intrahepatic cholangiocarcinoma: operative results and long-term outcome. Surgery 2008; 143: 366–374.
Saiura A, Yamamoto J, Kokudo N, et al. Intrahepatic cholangio-carcinoma: analysis of 44 consecutive resected cases including 5 cases with repeat resections. Am J Surg 2011; 201: 203–208.
Weber SM, Jarnagin WR, Klimstra D, et al. Intrahepatic cholangio-carcinoma: resectability, recurrence pattern, and outcomes. J Am Coll Surg 2001; 193: 384–391.
Ohtsuka M, Kimura F, Shimizu H, et al. Significance of repeated resection for recurrent intrahepatic cholangiocarcinoma. Hepatogastroenterology 2009; 56: 1–5.
Casaril A, Abu Hilal M, Harb A, et al. The safety of radiofrequency thermal ablation in the treatment of liver malignancies. Eur J Surg Oncol 2008; 34: 668–672.
Choi D, Lim HK, Kim MJ, et al. Recurrent hepatocellular carcinoma: percutaneous radiofrequency ablation after hepatectomy. Radiology 2004; 230: 135–141.
Yang W, Chen MH, Yin SS, et al. Radiofrequency ablation of recurrent hepatocellular carcinoma after hepatectomy: therapeutic efficacy on early- and late-phase recurrence. AJR Am J Roentgenol 2006; 186: S275–283.
Edmondson HA, Steiner PE. Primary carcinoma of the liver. A study of 100 cases among 48,900 necropsies. Cancer 1954; 7: 462–503.
Chen MH, Yang W, Yan K, et al. Large liver tumors: protocol for radiofrequency ablation and its clinical application in 110 patients. Radiology 2004; 232: 260–271.
Chen MH, Yang W, Yan K, et al. Radiofrequency ablation of problematically located hepatocellular carcinoma: tailored approach. Abdom Imaging 2008; 33: 428–436.
Frericks BB, Ritz JP, Roggan A, et al. Multipolar radiofrequency ablation of hepatic tumors: initial experience. Radiology 2005; 237: 1056–1062.
Goldberg SN, Grassi CJ, Cardella JF, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria. J Vasc Interv Radiol 2009; 20(Suppl): S377–390.
Zgodzinski W, Espat NJ. Radiofrequency ablation for incidentally identified primary intrahepatic cholangiocarcinoma. World J Gastroenterol 2005; 11: 5239–5240.
Chou FF, Sheen-Chen SM, Chen YS, et al. Surgical treatment of cholangiocarcinoma. Hepatogastroenterology 1997; 44: 760–765.
Gerhards MF, van Gulik TM, González González D, et al. Results of postoperative radiotherapy for resectable hilar cholangiocarcinoma. World J Surg 2003; 27: 173–179.
Serafini FM, Sachs D, Bloomston M. et al. Location, not staging, of cholangiocarcinoma determines the role for adjuvant chemoradiation therapy. Am Surg 2001; 67: 839–843.
Pitt HA, Nakeeb A, Abrams RA, et al. Perihilar cholangiocarcinoma. Postoperative radiotherapy does not improve survival. Ann Surg 1995; 221: 788–797.
Yonemoto N, Furuse J, Okusaka T, et al. A multi-center retrospective analysis of survival benefits of chemotherapy for unresectable biliary tract cancer. Jpn J Clin Oncol. 2007; 37: 843–851.
Thongprasert S. The role of chemotherapy in cholangiocarcinoma. Ann Oncol 2005; 16(Suppl 2): ii93–ii96.
Glimelius B, Hoffman K, Sjödén PO, et al. Chemotherapy improves survival and quality of life in advanced pancreatic and biliary cancer. Ann Oncol 1996; 7: 593–600.
Okusaka T, Ishii H, Funakoshi A, et al. Phase II study of single-agent gemcitabine in patients with advanced biliary tract cancer. Cancer Chemother Pharmacol 2006; 57: 647–653.
Kornek GV, Schuell B, Laengle F, et al. Mitomycin C in combination with capecitabine or biweekly high-dose gemcitabine in patients with advanced biliary tract cancer: a randomized phase II trial. Ann Oncol 2004; 15: 478–483.
Herber S, Otto G, Schneider J, et al. Transarterial Chemoembolization (TACE) for Inoperable Intrahepatic Cholangiocarcinoma. Cardiovasc Intervent Radiol 2007; 30: 1156–1165.
Vogl TJ, Schwarz W, Eichler K, et al. Hepatic intraarterial chemotherapy with gemcitabine in patients with unresectable cholangiocarcinomas and liver metastases of pancreatic cancer: a clinical study on maximum tolerable dose and treatment efficacy. J Cancer Res Clin Oncol 2006; 132: 745–755.
Burger I, Hong K, Schulick R, et al. Transcatheter arterial chemoembolization in unresectable cholangiocarcinoma: initial experience in a single institution. J Vasc Interv Radiol 2005; 16: 353–361.
Slakey DP. Radiofrequency ablation of recurrent cholangiocarcinoma. Am Surg 2002; 68: 395–397.
Oshima S, Takaishi K, Kurokawa E, et al. A case of successful management of recurrent intrahepatic cholangiocarcinoma by repeated radiofrequency ablations. Gan To Kagaku Ryoho (in Japanese) 2009; 36: 2404–2406.
Kim JH, Won HJ, Shin YM, et al. Radiofrequency ablation for recurrent intrahepatic cholangiocarcinoma after curative resection. Eur J Radiol 2010. Oct 13. [Epub ahead of print]
Chiou YY, Hwang JI, Chou YH, et al. Percutaneous ultrasound-guided radiofrequency ablation of intrahepatic cholangiocarcinoma. Kaohsiung J Med Sci 2005; 21: 304–309.
Poon RT, Ng KK, Lam CM, et al. Learning curve for radiofrequency ablation of liver tumors: prospective analysis of initial 100 patients in a tertiary institution. Ann Surg 2004; 239: 441–449.
Choy PY, Koea J, McCall J, et al. The role of radiofrequency ablation in the treatment of primary and metastatic tumours of the liver: initial lessons learned. N Z Med J 2002; 115: U128.
Mulier S, Mulier P, Ni Y, et al. Complications of radiofrequency coagulation of liver tumors. Br J Surg 2002; 89: 1206–1222.
Liang P, Wang Y, Yu X, et al. Malignant liver tumors: treatment with percutaneous microwave ablation—complications among cohort of 1136 patients. Radiology 2009; 251: 933–940.
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This work was supported by the National “863” High-Tech Res & Dev Program of China (No. 2007AA02Z4B8) and the National Science Foundation for Young Scholars of China (No. 81101745).
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Fu, Y., Yang, W., Wu, W. et al. Radiofrequency ablation for postoperative recurrences of intrahepatic cholangiocarcinoma. Chin. J. Cancer Res. 23, 295–300 (2011). https://doi.org/10.1007/s11670-011-0295-9
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DOI: https://doi.org/10.1007/s11670-011-0295-9