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J Vasc Interv Radiol. 2019 Apr 5. pii: S1051-0443(18)31825-6. doi: 10.1016/j.jvir.2018.12.030. [Epub ahead of print]

Safety and Efficacy of Percutaneous Cryoablation for Small Hepatocellular Carcinomas Adjacent to the Heart.

Author information

1
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul 120-752, Korea.
2
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul 120-752, Korea. Electronic address: JYWON@yuhs.ac.

Abstract

PURPOSE:

This study evaluated the safety and efficacy of percutaneous cryoablation for treatment of the left subdiaphragmatic small hepatocellular carcinomas (HCCs) adjacent to the heart.

MATERIALS AND METHODS:

Between September 2013 and March 2018, 189 consecutive patients underwent cryoablation for small HCCs (≤3 cm); 70 patients (mean: 61.3 ± 10.6 years of age; range: 40-82 years) with left hepatic tumors (22 juxtacardiac and 48 nonjuxtacardiac tumors) were retrospectively analyzed. Patients were divided into juxtacardiac and nonjuxtacardiac tumor groups (tumor margins: ≤10 mm and >10 mm, respectively, from the heart border). The rates of technical success, complete ablation, complications, and local tumor recurrence (LTR) were evaluated.

RESULTS:

No significant intergroup differences were observed in the mean diameter of the tumor (17.9 ± 5.5 mm vs. 17.5 mm ± 5.2, respectively; P = 0.781) and of the ablation zone (41.3 ± 4.2 mm vs. 43.5 ± 5.8 mm, respectively; P = 0.115). Technical success was achieved in all patients. No procedure-related major complications occurred in either group. The median follow-up period was 15 months (range: 3.1-49.6 months). No statistically significant intergroup differences were observed in the rates of complete ablation (90.9% vs. 93.8%, respectively; P = 0.646) and LTR (20% vs. 15.6%, respectively; P = 0.725).

CONCLUSIONS:

Cryoablation is a safe treatment modality for patients with juxtacardiac small HCCs, without an increased risk of cardiac complications compared to treatment of HCCs that are nonjuxtacardiac, and with comparable efficacy.

PMID:
30956074
DOI:
10.1016/j.jvir.2018.12.030

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