Clinical efficacy of ultrasound-guided thermal ablation in treatment of rare liver tumors

doi:10.3877/cma.j.issn.2095-3232.2018.06.015

Abstract

Abstract:

Objective

To investigate the safety and efficacy of ultrasound-guided thermal ablation in the treatment of rare liver tumors.

Methods

Clinical data of 9 patients with rare liver tumors who underwent ultrasound-guided thermal ablation from January 2012 to December 2016 in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among 9 cases (14 lesions), 2 patients were male and 7 female, aged (42±12) years on average. All the patients underwent ultrasound or contrast-enhanced ultrasound-guided puncture and thermal ablation of the tumors. The ablation effect was evaluated immediately by contrast-enhanced ultrasound during the operation. The incidence of postoperative complications was observed. The complete ablation rate was evaluated by CT or MRI at postoperative1 month.

Results

11 lesions were treated with common ultrasound-guided thermal ablation and 3 lesions with contrast-enhanced ultrasound-guided ablation. The intraoperative complete ablation rate was 100% (14/14), and the rate at postoperative 1 month was also 100% (14/14). No ablation related complications was observed. During the follow-up, no local tumor progression or intrahepatic and extrahepatic tumors recurrence was observed in all patients.

Conclusions

For rare liver tumors, ultrasound-guided thermal ablation can achieve the effect of complete ablation, providing a new therapeutic option for the patients.

Key words: Liver neoplasms, Ultrasonography, interventional, Catheter ablation

Lili Wu, Jiaxin Chen, Kai Li, Zhongzhen Su, Qingjin Zeng, Yinglin Long, Liping Luo, Erjiao Xu, Rongqin Zheng. Clinical efficacy of ultrasound-guided thermal ablation in treatment of rare liver tumors[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2018, 07(06): 495-498.

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References 21

[1]	Bruix J, Sherman M, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update[J]. Hepatology, 2011, 53(3):1020-1022.
[2]	European Association For The Study Of The Liver, European Organisation For Research And Treatment Of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma[J]. J Hepatol, 2012, 56(4):908-943.
[3]	Lee DH, Lee JM. Primary malignant tumours in the non-cirrhotic liver[J]. Eur J Radiol, 2017, 95:349-361.
[4]	Dietrich CF, Lorentzen T, Appelbaum L, et al. EFSUMB guidelines on interventional ultrasound (INVUS), part Ⅲ-abdominal treatment procedures (long version)[J]. Ultraschall Med, 2016, 37(1):E1-32.
[5]	Feng K, Yan J, Li X, et al. A randomized controlled trial of radiofrequency ablation and surgical resection in the treatment of small hepatocellular carcinoma[J]. J Hepatol, 2012, 57(4):794-802.
[6]	Kudo M, Matsui O, Izumi N, et al. JSH consensus-based clinical practice guidelines for the management of hepatocellular carcinoma: 2014 update by the Liver Cancer Study Group of Japan[J]. Liver Cancer, 2014, 3(3/4):458-468.
[7]	Van Beers BE, Daire JL, Garteiser P. New imaging techniques for liver diseases[J]. J Hepatol, 2015, 62(3):690-700.
[8]	Belghiti J, Cauchy F, Paradis V, et al. Diagnosis and management of solid benign liver lesions[J]. Nat Rev Gastroenterol Hepatol, 2014, 11(12):737-749.
[9]	Tominaga K, Kamimura K, Sakamaki A, et al. Intraductal papillary neoplasm of the bile duct: a rare liver tumor complicated by malignancy[J]. Hepatology, 2017, 66(5):1695-1697.
[10]	李增才, 张斌, 王轩, 等. 成人肝脏少见肿瘤或肿瘤样变18例临床观察[J]. 临床肿瘤学杂志, 2015, 20(9):837-840.
[11]	李明信, 朱贤胜, 陈育洪, 等. 肝炎性肌纤维母细胞瘤超声表现[J]. 临床超声医学杂志, 2015, 18(1): 72,封3.
[12]	Tapper EB, Lok ASF. Use of liver imaging and biopsy in clinical practice[J]. N Engl J Med, 2017, 377(23):2296-2297.
[13]	孙一欣, 程文, 杨洪艳, 等. 超声造影对提高肝多发占位穿刺活检的应用价值[J]. 中国临床医学影像杂志, 2013, 24(5):325-327, 333.
[14]	郭曦, 唐继红, 付必莽, 等. 45例肝脏少见良性实性占位性病变的临床诊治分析[J]. 肝胆外科杂志, 2012, 20(3):174-176.
[15]	Chinnaratha MA, Chuang MY, Fraser RJ, et al. Percutaneous thermal ablation for primary hepatocellular carcinoma: a systematic review and meta-analysis[J]. J Gastroenterol Hepatol, 2016, 31(2):294-301.
[16]	中华人民共和国国家卫生和计划生育委员会. 原发性肝癌诊疗规范（2017年版）[J]. 临床肝胆病杂志, 2017, 33(8):1419-1431.
[17]	步向阳, 王一, 葛忠, 等. 小肝癌射频消融与手术切除的疗效比较[J/CD]. 中华普通外科学文献（电子版）, 2009, 3(2):127-13.
[18]	Ahmed M, Solbiati L, Brace CL, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria--a 10-year update[J]. Radiology, 2014, 273(1):241-260.
[19]	高孟, 李开艳, 罗洪昌, 等. 原发性小肝癌超声引导下经皮微波消融与手术切除疗效的对比研究[J]. 中华超声影像学杂志, 2015, 24(1):35-39.
[20]	Claudon M, Dietrich CF, Choi BI, et al. Guidelines and good clinical practice recommendations for Contrast Enhanced Ultrasound (CEUS) in the liver-update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS[J]. Ultrasound Med Biol, 2013, 39(2):187-210.
[21]	陈敏华, 严昆, 戴莹, 等. 肝超声造影应用指南（中国）（2012年修改版）[J]. 中华超声影像学杂志, 2013, 22(8):696-722.

例序	年龄（岁）	性别	病灶直径（mm）	病灶回声	病理诊断
1	29	女	27	高回声团	炎性假瘤样滤泡树突状细胞肿瘤
2	47	女	14	低回声团	炎症性肌纤维母细胞瘤
3	46	女	22	低回声团	炎性肌纤维母细胞瘤
4^a	64	女	21、9、7	低-无回声	黏膜相关淋巴组织结外边缘区淋巴瘤
5^b	36	女	15、32	高回声团	肝腺瘤
6^b	34	女	8、13	低回声团	脾脏炎性肌纤维母细胞肿瘤肝转移瘤
7	28	男	14	低回声团	组织细胞和树突细胞肿瘤
8^b	49	女	14、6	低回声团	B细胞源性淋巴瘤或树突状细胞肿瘤
9	47	男	22	低回声团	EB病毒相关淋巴上皮瘤样胆管癌

例序	年龄（岁）	性别	病灶直径（mm）	病灶回声	病理诊断
1	29	女	27	高回声团	炎性假瘤样滤泡树突状细胞肿瘤
2	47	女	14	低回声团	炎症性肌纤维母细胞瘤
3	46	女	22	低回声团	炎性肌纤维母细胞瘤
4^a	64	女	21、9、7	低-无回声	黏膜相关淋巴组织结外边缘区淋巴瘤
5^b	36	女	15、32	高回声团	肝腺瘤
6^b	34	女	8、13	低回声团	脾脏炎性肌纤维母细胞肿瘤肝转移瘤
7	28	男	14	低回声团	组织细胞和树突细胞肿瘤
8^b	49	女	14、6	低回声团	B细胞源性淋巴瘤或树突状细胞肿瘤
9	47	男	22	低回声团	EB病毒相关淋巴上皮瘤样胆管癌

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