Author information
1
Department of Radiology, Section of Interventional Oncology- Microinvasive Therapy.
2
Department of Medicine II Gastroenterology and Hepatology.
3
Department of Transplant Surgery.
4
Department of Pathology, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
5
INNPATH, Institute of Pathology, Tirol Kliniken Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
Abstract
BACKGROUND AND RATIONALE FOR THE STUDY:
This retrospective study was performed to evaluate the efficacy of 3D-navigated multi-probe radiofrequency ablation (RFA) with intraprocedural image fusion for the treatment of hepatocellular carcinoma (HCC) by histopathologic examination.
MAIN RESULTS:
From 2009 to 2018, 97 patients (84 men, 13 women; median age 60 years, range 1 -71) were transplanted after bridging therapy of 195 HCCs by stereotactic RFA (SRFA). The median interval between the first SRFA and transplantation was 6.8 months (range: 0 - 71). The rate of residual vital tissue (RVT) could be assessed in 188/195 lesions in 96/97 patients by histological examination of the explanted livers using Hematoxylin & Eosin (H&E) and TUNEL stains. The histopathologic results were compared with the findings of the last CT imaging prior to LT. The median number and size of the treated tumors were 1 (range: 1-8) and 2.5 cm (range: 1-8 cm). Complete radiological response was achieved in 186/188 nodules (98.9%) and 94/96 patients (97.9%) and complete pathological response in the explanted liver specimen in 183/188 nodules (97.3%) and 91/96 patients (94.8%), respectively. In lesions ≥3 cm complete tumor cell death was achieved in 50/52 nodules (96.2%). Residual tumor did not correlate with tumor size (p = 0.5).
CONCLUSIONS:
Multi-probe SRFA with intraprocedural image fusion represents an efficient minimal invasive therapy for HCC, even with tumor sizes larger than 3cm, and without the need of a combination with additional treatments. The results seem to justify the additional efforts related to the stereotactic approach.