Percutaneous thermo-ablation (TA) may be unfeasible for the tumor location: laparoscopic ablation therapies (LATs) are an alternative option. The aim of this study is to assess the efficacy of LATs in the treatment of HCC not eligible for percutaneous TA or surgical resection. LAT was offered to 503 patients fulfilling at least one of the following criteria: (a) patients with a single nodule or up to three nodules smaller than 3 cm not suitable for surgery; (b) patients not suitable for percutaneous TA; (c) short-term recurrence of HCC (< 3 months). Technical success was achieved with one session in 467 patients (93%). One-month mortality and severe morbidity rates were 0.4% and 2.19%, respectively. During a median follow-up of 38.4 months in the remaining 501 patients, 361 (67%) developed intrahepatic recurrence: it appeared as a local tumor progression (LTP) in 74 cases (15%). Subcapsular lesions showed lower LTP rates (p = 0.008), as well as HCC nodules contiguous to viscera (p = 0.012). In the treatment of HCC, LAT has proved to be a safe and effective technique that enables to treat lesions not eligible for percutaneous approach, with a low morbidity rate.

Laparoscopic ablation therapies for hepatocellular carcinoma: could specific indications for the laparoscopic approach influence the effectiveness? / R. Santambrogio, M. Barabino, E. De Nicola, E. Galfrascoli, M. Giovenzana, M.A. Zappa. - In: UPDATES IN SURGERY. - ISSN 2038-131X. - 72:2(2020 Jun 01), pp. 435-443. [10.1007/s13304-020-00759-w]

Laparoscopic ablation therapies for hepatocellular carcinoma: could specific indications for the laparoscopic approach influence the effectiveness?

M. Barabino
Secondo
;
M. Giovenzana
Penultimo
;
2020

Abstract

Percutaneous thermo-ablation (TA) may be unfeasible for the tumor location: laparoscopic ablation therapies (LATs) are an alternative option. The aim of this study is to assess the efficacy of LATs in the treatment of HCC not eligible for percutaneous TA or surgical resection. LAT was offered to 503 patients fulfilling at least one of the following criteria: (a) patients with a single nodule or up to three nodules smaller than 3 cm not suitable for surgery; (b) patients not suitable for percutaneous TA; (c) short-term recurrence of HCC (< 3 months). Technical success was achieved with one session in 467 patients (93%). One-month mortality and severe morbidity rates were 0.4% and 2.19%, respectively. During a median follow-up of 38.4 months in the remaining 501 patients, 361 (67%) developed intrahepatic recurrence: it appeared as a local tumor progression (LTP) in 74 cases (15%). Subcapsular lesions showed lower LTP rates (p = 0.008), as well as HCC nodules contiguous to viscera (p = 0.012). In the treatment of HCC, LAT has proved to be a safe and effective technique that enables to treat lesions not eligible for percutaneous approach, with a low morbidity rate.
Hepatocellular carcinoma; Laparoscopic ultrasound; Liver cirrhosis; Radiofrequency ablation; Adult; Aged; Aged, 80 and over; Carcinoma, Hepatocellular; Endosonography; Female; Follow-Up Studies; Hepatectomy; Humans; Laparoscopy; Liver Neoplasms; Male; Middle Aged; Neoplasm Recurrence, Local; Patient Selection; Radiofrequency Ablation; Safety; Treatment Outcome
Settore MED/18 - Chirurgia Generale
apr-2020
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/821706
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