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Abstract:

Aim: was to develop a score scale for the prediction of complete tumor necrosis to assess the potential effectiveness of radiofrequency ablation of colorectal cancer focals in liver, on the base of results of the use of radiological diagnostic methods.

Materials and methods: a comparative analysis of results of radiological diagnosis of solitary colorectal cancer metastases in liver was carried out in 51 patients, depending on their characteristics before and at different times after radiofrequency ablation (RFA).

The survey and interventions were carried out between 2014 and 2020 in accordance with standards of treatment approved in Belarus. Ultrasound and CT with bolus contrast enhancement were used as radiation diagnostic methods.

The initial morphological parameters of tumor focals were evaluated according to results of ultrasound examination. CT with bolus contrast was used to control the effectiveness of RFA (determining the frequency of complete tumor necrosis): on the day of discharge of patients from the hospital, after 1 month, and then - once every 3 months (quarterly) during the year.

Results: the dependence of the effectiveness of RFA (frequency of complete tumor necrosis) on initial characteristics of solitary focals of colorectal cancer in liver was revealed and confirmed by results of a comparative statistical analysis. On the basis of obtained data, a score scale for predicting the effectiveness of RFA was developed and validated. The sensitivity of the new technique was 80,0%; specificity - 82,9%.

Conclusion: for the first time, a scale for the prediction of complete tumor necrosis was developed to assess the potential effectiveness of radiofrequency ablation of solitary colorectal cancer focals in liver.

ROC-analysis of the scale validation results showed that the sensitivity and specificity of the model are sufficient for its application in practice: 80,0% and 82,93%, respectively.

 

References

1.     Hideo T, Eren B. Role of thermal ablation in the management of colorectal liver metastasis. Hepatobiliary Surg. Nutr. 2020; 9(1): 49-58.

https://doi.org/10.21037/hbsn.2019.06.08

2.     Machi J, Oishi AJ, Nancy LF, Robert HO. Sonographically guided radio frequency thermal ablation for unresectable recurrent tumors in the retroperitoneum and the pelvis. J. Ultrasound. Med. 2003; 22(5): 507-13.

https://doi.org/10.7863/jum.2003.22.5.507

3.     Furrukh J, Cameron S, Iswanto S. The use of thermal ablation in the treatment of colorectal liver metastasis-proper selection and application of technology. Hepatobiliary Surg. Nutr. 2021; 10(2): 279-280.

https://doi.org/10.21037/hbsn-21-54

4.     Vasiniotis KN, Kaye EA, Sofocleous CT. Image-Guided Thermal Ablation for Colorectal Liver Metastases. Tech. Vasc. Interv. Radiol. 2020; 23(2): 100672.

https://doi.org/10.1016/j.tvir.2020.100672

5.     Rafael D-N, Stephen F, Hassan M, Graeme P. Defining the Optimal Use of Ablation for Metastatic Colorectal Cancer to the Liver Without High-Level Evidence. Curr. Treat. Options. Oncol. 2017; 18(2): 8.

https://doi.org/10.1007/s11864-017-0452-6

6.     Мурашко К.Л., Сорокин В.Г., Громов Д.Г. Методы локального воздействия на очаговые образования печени, применяемые в онкорадиологии. Диагностическая и интервенционная радиология. 2020;14: 60-66.

Murashko KL, Sorokin VG, Gromov DG. Metody lokal'nogo vozdejstviya na ochagovye obrazovaniya pecheni, primenyaemye v onkoradiologii. Diagnosticheskaya i intervencionnaya radiologiya. 2020; 14: 60-66 [In Russ].

https://doi.org/10.25512/DIR.2020.14.2.07

7.     Binbin J, Hongjie L, Kun Y, Zhongyi Z. Ten-Year Outcomes of Percutaneous Radiofrequency Ablation for Colorectal Cancer Liver Metastases in Perivascular vs. Non-Perivascular Locations: A Propensity-Score Matched Study. Front. Oncol. 2020; 16(10): 553556.

https://doi.org/10.3389/fonc.2020.553556

8.     Lu DSK, Steven SR, Limanond P, et al. Influence of large peritumoral vessels on outcome of radiofrequency ablation of liver tumors. J. Vasc. Interv. Radiol. 2003; 14(10): 1267-74.

https://doi.org/10.1097/01.rvi.0000092666.72261.6b

9.     Lu DS, et al. Effect of vessel size on creation of hepatic radiofrequency lesions in pigs: Assessment of the “heat sink” effect. Am. J. Roentgenol. 2002; 178: 47-51.

https://doi.org/10.2214/ajr.178.1.1780047

10.   You L, Hui H, Ziwei W, et al. Evaluation of models for predicting the probability of malignancy in patients with pulmonary nodules. Biosci. Rep. 2020; 28; 40(2): BSR20193875.

https://doi.org/10.1042/BSR20193875

11.   Wang QQ, Yu SC, Qi X, et al. Overview of logistic regression model analysis and application. Zhonghua Yu. Fang. Yi. Xue. Za. Zhi. 2019; 6; 53(9): 955-960.

https://doi.org/10.3760/cma.j.issn.0253-9624.2019.09.018

12.   Adina NK, Trevor C, Ruwanthi K-D. Time-dependent ROC curve analysis in medical research: current methods and applications. BMC Med. Res. Methodol. 2017; 17(1): 53.

https://doi.org/10.1186/s12874-017-0332-6

13.   Nakas CT, Reiser B. Editorial for the special issue of “Statistical Methods in Medical Research” on “Advanced ROC analysis”. Statistical Methods in Medical Research. 2018; 27(3): 649-650.

https://doi.org/10.1177/0962280217742536

14.   Xieling C, Haoran X, Fu L, et al. A bibliometric analysis of natural language processing in medical research. BMC Med. Inform. Decis. Mak. 2018; 18(1): 14.

https://doi.org/10.1186/s12911-018-0594-x

15.   Young C, Soung WJ, Jae YJ, Yong JK. Recent Updates of Transarterial Chemoembolilzation in Hepatocellular Carcinoma. Int. J. Mol. Sci. 2020; 31; 21(21): 8165.

https://doi.org/10.3390/ijms21218165

16.   Riccardo L. Loco-regional treatment of hepatocellular carcinoma. Hepatology. 2010; 52(2): 762-73.

https://doi.org/10.1002/hep.23725

17.   Hinshaw JL, Lubner MG, Ziemlewicz TJ, et al. Percutaneous tumor ablation tools: microwave, radiofrequency, or cryoablation - what should you use and why? Radiographics. 2014; 34(5): 1344-62.

https://doi.org/10.1148/rg.345140054

18.   Pierre A, Roberto LC, Guillaume K, et al. Percutaneous tumor ablation. Presse. Med. 2019; 48(10): 1146-1155.

https://doi.org/10.1016/j.lpm.2019.10.011

19.   Fan Z, Hongying S, Xiangjun H, et al. Tumor Thermal Ablation Enhancement by Micromaterials. Curr. Drug. Deliv. 2017; 14(3): 323-333.

https://doi.org/10.2174/1567201813666160108114208

20.   Mehta A, Oklu R, Sheth RA. Thermal Ablative Therapies and Immune Checkpoint Modulation: Can Locoregional Approaches Effect a Systemic Response? Gastroenterol. Res. Pract. 2016; 9251375.

https://doi.org/10.1155/2016/9251375

 

Abstract:

Aim: was to analyze domestic and foreign literature sources, reflecting the possibility of applying local ablation methods of focal liver tumors.

Material and methods: article presents an analysis of domestic and foreign 37 publications containing information on the use of methods of local ablation of nodular pathology of liver, deposited in resources of PubMed and information portal eLIBRARY.RU.

Results: most important aspects of performing of methods of chemical, cryo-, microwave, and radiofrequency ablations, used in treatment of local liver tumors were presented.

Conclusion: analysis of various publications on methods of local destruction of tumors does not give a clear answer to the question of which method is preferred, however, article describes each of ablation methods, highlighting positive and negative aspects of their effect on lesions of the liver. The question of the inclusion of minimally invasive methods in schemes of combined and complex antitumor therapy for focal liver lesions also remains open.

Modern approaches and improving techniques of treatment of liver malignancies, expand indications for the use of minimally invasive techniques. Competent selection of patients, selection of the optimal method of local ablation of tumor and subsequent dynamic monitoring of patients reduce the number of relapses, increase the percentage of overall survival of patients and improve their quality of life.

  

References

1.     Truty MJ, Vauthey J-N. Surgical resection of highrisk hepatocellular carcinoma: patient selection, preoperative considerations, and operative technique. Ann. Surg. Oncol. 2010; 17: 1219-1225.

2.     Gillams AR. Radiofrequency ablation in the management of liver tumors. Eur. J. Surg. Oncol. 2003; 29(1): 9-16.

3.     Patjutko JuI, Chuchuev ES, Podluzhnyj DV, et al. Surgical tactics in treatment of colorectal cancer patients with synchronous liver metastases. Onkologicheskaja koloproktologija. 2011; 2: 13-19. [In Russ].

4.     Liu LX, Zhang WH, Jiang HC. Current treatment for liver metastases from colorectal cancer. World J. Gastroenterol. 2003; 9: 193-200.

5.     Patjutko JuI, Sagajdak IV. Indications and contraindications for liver resections in case of metastases of colorectal cancer. The value of prognostic factors and their classification. Ann. Hir. Gepatol. 2003; 8(1): 110-118 [In Russ].

6.     Granov DA, Tarazov PG. Endovascular interventions in treatment of malignant tumors of the liver. SPb. Foliant. 2002; 287 [In Russ].

7.     Verjasova NN. Treatment of malignant tumors of the liver with the use of local injection therapy with ethanol. CNIIRI. SPb. Avtoreferat. 2002; 6-8 [In Russ].

8.     Sugiura Y, Nakamura S, Iida S, et. al. Extensive resection of the bile ducts combined with liver resection for cancer of the main hepatic duct junction: A cooperative study of the Keio Bile Duct Cancer Study Group. Surgery. 1994; 15(4): 445-451.

9.     Elgindy N, Lindholm H, Gunvйn P. High dose percutaneous ethanol injection therapy of liver tumors: patient acceptance and complications. Acta Radiologica. 2000; (5): 458-463.

10.   Shaposhnikov AV, Bordshkov JuN, Nepomnjashhaja EM, at al. Local therapy of unresectable liver tumors. Ann. Hir. Gepatol. 2004; 9(1): 89-94 [In Russ].

11.   Siperstein AE, Berber E. Cryoablation, Percutaneous Alcohol Injection, and Radiofrequency Ablation for Treatment of Neuroendocrine Liver Metastases. World. J. Surg. 2001; (25): 693-696.

12.   Chu KF, Dupuy DE. Thermal ablation of tumours: biological mechanisms and advances in therapy. Nat. Rev. Cancer. 2014; 3: 199-208.

13.   Adam R, Akpinar E, Johann M, et al. Place of cryosurgery in the treatment of malignant liver tumors. Ann Surg. 1997; 225: 239–250.

14.   Mala T. Cryoablation of colorectal liver metastases: minimally invasive tumor control. Scand. J. Gastroenter. 2004; 39: 571-578.

15.   Samojlov VA, Saljukov JuL, Gladenko AA, et al. Experience in the use of cryodestruction in treatment of metastatic liver cancer. Ann. Hir. Gepatol. 1998; 3: 326 [In Russ].

16.   Seifert JK, Junginger T, Morris DL. A collective review of the world literature on hepatic cryotherapy. J.R. Coll. Surg. Edinb. 1998; 43: 141-154.

17.   Erinjeri JP, Clark TW. Cryoablation: mechanism of action and devices. J Vasc Interv Radiol. 2010; 21: 187-191.

18.   Ahmed M, Brace CL, Lee FT, at al. Principles of and advances in percutaneous ablation. Radiology. 2011; 258(2): 351-369.

19.   Chu KF, Dupuy DE. Thermal ablation of tumours: biological mechanisms and advances in therapy. Nat. Rev. Cancer. 2014; 14(3): 199-208.

20.   Starkov JuG, Shishin KV. Cryosurgery of focal liver lesions. Hirurgija. 2000; 7: 53-59 [In Russ].

21.   Hinshaw JL, Lubner MG, Ziemlewicz TJ, et al. Percutaneous tumor ablation tools: microwave, radiofrequency, or cryoablation – what should you use and why? Radiographics. 2014; 34(5): 1344-1362.

22.   Ravikumar TS, Kane R, Cady B, et al. A 5-year study of cryosurgeryin the treatment of liver tumors. Arc. Hir. Surg. 1991; 125: 1520-1524.

23.   Crews KA, Kuhn JA, McCarty TM, et al. Cryosurgical ablation of hepatic tumors. Am. J. Surg. 1997; 174: 614-617.

24.   Lubner MG, Brace CL, Hinshaw JL et al. Microwave tumor ablation: mechanism of action, clinical results, and devices. J. Vasc. Interv. Radiol. 2010; 21: 192-203.

25.   Lencioni R, de Baere T, Martin RC, at al. Imageguided ablation of malignant liver tumors: recommendations for clinical validation of novel thermal and non-thermal technologies - a western perspective. Liver Cancer. 2015; (4): 208–214.

26.   Mayo SC, Pawlik TM. Thermal ablative therapies for secondary hepatic malignancies. Cancer J. 2010; 16 (2): 111-117.

27.   Scudamore CH, Patterson EJ, Shapiro AM, et al. Liver tumor ablation techniques. J. Invest. Surg. 1997; 4: 157-64.

28.   Brace C. Thermal tumor ablation in clinical use. IEEE Pulse. 2011; (5):28-38.

29.   Iannitti DA, Martin RC, Simon CJ, et al. Hepatic tumor ablation with clustered microwave antennae. The US Phase II trial. HPB (Oxford). 2007; 9(2): 120.

30.   Rossi S, Carbagnati P, Rosa L, et al. Laparoscopic radio frequency thermal ablation for treatment of hepatocelluar carcinoma. Int. J. Clin. Oncol. 2002; 225-235.

31.   Zivin SP, Gaba RC. Technical and practical considerations for device selection in locoregional ablative therapy. Semin. Intervent. Radiol. 2014: 31(2): 212-24.

32.   Mehta A, Oklu R, Sheth RA. Thermal ablative therapies and immune checkpoint modulation: can locoregional approaches effect a systemic response? Gastroenterology Research and Practice. 2016; 9251375: 11.

33.   Sidana A. Cancer immunotherapy using tumor cryoablation. Immunotherapy. 2014; 6(1): 85-93.

34.   Dolgushin BI, Patjutko JuI, Sholohov VN, et al. Radiofrequency thermal ablation of liver tumors. Edited by MI Davydov. Prakticheskaja medicina. 2007; 192 [In Russ].

35.   Fedorov VD, Vishnevskij VA, Kornjak BS, at al. Radiofrequency ablation of malignant tumors of the liver (literature review). Hirurgija. 2003; 10: 77-80 [In Russ].

36.   Machi J, Oishi AJ, Mossing AJ, Furumoto NL, Oishi RH. Hand-assisted laparoscopic ultrasound-guided radiofrequency thermal ablation of liver tumors: a technical report. Surg Laparosc Endosc Percutan Tech. 2002; 12:160–164.

37.   Gilliams AR, Lees WR. CT mapping of the distribution of saline during radiofrequency ablation with perfusion electrodes. Cardiovasc Intervent Radiol. 2005; 476-480.

Abstract:

Radiofrequency (RF) ablation is a minimally invasive method. Application of RF ablation allowed to expand indications for more radical treatment of kidney tumors in patients, whom traditional nephrectomy or kidney resection are impossible, due to extremely adverse somatic status

Efficiency and safety of RF ablation are significantly increased if preceded in combination with superselective occlusion of blood vessels, supplying the tumor. We possess the experience of application of superselective embolization in combination with RF ablation of two patients with kidney tumors. In both cases a good result of combined treatment has been observed.

This combination (superselective embolization + RF ablation) can be an alternative to open operation on kidney in number of patients, expanding the arsenal of modern minimally invasive kidney tumor's treatment methods. 

 

Reference 

1.    Pavlov AJu., Klimenko A. A., Momdzhan B.K., Ivanov S.A. Radiochastotnaja intersticial'naja termoabljacija (RChA) raka pochki. [Radiofrequency interstitial termal ablation of renal cancer]. Jeksperimental'naja i klinicheskaja urologija. 2011; 2(3): 112-113 [In Russ].

2.    European Network of Cancer Registries. Eurocim version 4.0. European incidence database V2.3, 730 entity dictionary (2001). Lyon, 2001.

3.    Zlokachestvennye novoobrazovanija v Rossii v 2008 g. (zabolevaemost' i smertnost'). [Malignant neoplasms in Russian Federation in 2008 (morbidity and mortality)]. Pod red. V.I. Chissova, V.V. Starinskogo, G.V. Petrovoj. M. FGU «MNIOI im. P.A. Gercena Rosmedtehnologij». 2010 [ In Russ].

4.    Chow W.H., Devesa S.S., Warren J.L., Freumeni J.FJr. Rising incidence of renal cell carcer in the United States. JAMA. 1999; 281:1628-31.

5.    Nguyen M.M., ill I.S., Ellison L.M. The evolving presentation of renal carcinoma in the United States: trends from the Surveillance, Epidemiology, and End Results program. J. Urol. 2006; 176: 2397-400; discussion 2400.

6.    Kummerlin I.P., ten Kate F.J., Wijkstra H., de la Rosette J.J., Laguna M.P. Changes in the stage and surgical management of renal tumours during 1995-2005: an analysis of the Dutch national histopathology registry. BJU Int. 2008; 102 (8): 946-51. Epub 2008 Jun 28.

7.    Ankem M.K., Nakada S.Y. Needle-nephron-sparing surgery. BJU Int. 2005; 95 (2): 46-51.

8.    Havranek E., Anderson C. Future prospects for nephron conservation in renal cell carcinoma. In: Kirby R.S., O’Leary M.P., editors. Hot topics in urology. Amsterdam. The Netherlands: Elsevier. 2004; 227-38.

9.    Marberger M., Mauerman J. Energy ablation nephron-sparing treatment of renal tumors. AUA Update Series. 2004; 23:178-83.

10.  Reddan D.N., Raj G.V., Polascik TJ. Management of small renal tumors: an overview. Am. J. Med. 2001; 110: 558-62.

11.  Weld K.J., Landman L. Comparison of cryoablation, radiofrequency ablation and high-intensity focused ultrasound for treating small renal tumors. BJU Int. 2005; 96:1224-9.

12.  Uzzo R.G., Novick A.C. Nephron sparing surgery for renal tumors: indications techniques and outcomes. J. Urol. 2001; 166:6-18.

13.  Dolgushin B.I., Kosyrev VJu., Ramprabanant S. Radiochastotnaja ablacija v onkologii. Prakticheskaja onkologija. 2007; 8(4): 219-227 [In Russ].

14.  Vogl TJ., Helmberger T.K., Mack M.G., Reiser M.F. (Eds.) Percutaneous Tumor Ablation in Medical Radiology. ISBN 978-3-540-22518-8 Springer. Berlin. Heidelberg. New York. 2008.

15.  Winthrop H. Hal, John P. McGahan, Daniel P. Link and Ralph W. deVere White. Combined Embolization and Percutaneous Radiofrequency Ablation of a Solid Renal Tumor. AJR. 2000; 174:1592-1594.

16.  Yamakado K., Nakatsuka A., Kobayashi S., Akeboshi M., Takaki H., Kariya Z., Kinbara H., Arima K., Yanagawa M., Hori Y., Kato H., Sugimura Y., Takeda K. Radiofrequency ablation combined with renal arterial embolization for the treatment of unresectable renal cell carcinoma larger than 3.5 cm: initial experience. Cardiovasc. Intervent. Radiol. 2006; 29(3): 389-94.

17.  Klingler H.C., Marberger M., Mauermann J. et al. ’Skipping’ is still a problem with radiofrequency ablation of small renal tumours. BJU Int. 2007; 99: 998-1001.

18.  Goldberg S.N., Gazelle G.S., Mueller P.R. Thermal ablation therapy for focal malignancy: A unified approach to underlying principles, techniques and diagnostic imaging guidance. Am. J. Roentgenol. 2000; 174: 323-31.

19.  Lee M. Ellis, Steven A. Curley, Kenneth K. Tanabe. Radiofrequency Ablation for Cancer.Current Indications, Techniques, and Outcomes. 2004; Springer-Verlag New York, Inc.

20.  Salagierski M., Salagierski M. Radiofrequency ablation partial nephrectomy: a new method of nephron-sparing surgery in selected patients. Int. J. Urol. 2006; 13(11): 1456-9.

21.  Veltri A., Garetto I., Pagano E., Tosetti I., Sacchetto P., Fava C. Percutaneous RF termal ablation of renal tumors: is US guidance really less favorable than other imaging guidance techniques? Cardiovasc. Intervent. Radiol. 2009; 32(1): 76-85. Epub 2008 Aug 15.

22.  Schirmang T.C., Mayo-Smith W.W., Dupuy D.E., Beland M.D., Grand D.J. Kidney neoplasms: renal halo sign after percutaneous radiofrequency ablation-incidence and clinical importance in 101 consecutive patients. Radiology. 2009; 253(1): 263-9. Epub 2009 Jul. 31.

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