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. 2012 Aug;85(1016):1078-84.
doi: 10.1259/bjr/24563774. Epub 2012 Feb 28.

Percutaneous ultrasound-guided thermal ablation for intrahepatic cholangiocarcinoma

H-X Xu  1 , Y Wang, M-D Lu, L-N Liu
Affiliations

Percutaneous ultrasound-guided thermal ablation for intrahepatic cholangiocarcinoma

H-X Xu et al. Br J Radiol. 2012 Aug.

Abstract

Objective: The objective of this study was to evaluate the treatment efficacy and overall survival (OS) of percutaneous ultrasound-guided thermal ablation by means of microwave ablation or radiofrequency ablation for intrahepatic cholangiocarcinoma (ICC).

Methods: 18 patients with 25 ICC nodules underwent ultrasound-guided thermal ablation with curative intention. 8 patients were primary cases and 10 were recurrent cases after curative resection. The local treatment response, complications and survivals were analysed.

Results: Complete ablation was achieved in 23 (92.0%, 23/25) nodules (diameter, 0.7-4.3 cm; mean, 2.5 ± 0.9 cm) and incomplete ablation was found in 2 (8.0%, 2/25) larger tumours (6.4 and 6.9 cm in diameter). No death associated with the treatment was found. The major complication rate was 5.5% (1/18). The follow-up periods ranged from 1.3 to 86.2 months (mean, 20.5 ± 26.3 months; median, 8.7 months). OS rates for all patients at 6, 12, 36 and 60 months were 66.7%, 36.3%, 30.3% and 30.3%, respectively. By univariate analysis, the patient source (primary or recurrent case) was found to be a significant prognostic factor for OS rates (p=0.001). The patient source (p=0.001) and the number of nodules (p=0.038) were found to be significant prognostic factors for recurrence-free survival. OS rates for the primary ICC at 6, 12, 36 and 60 months were 87.5%, 75.0%, 62.5% and 62.5%, respectively.

Conclusion: Percutaneous ultrasound-guided thermal ablation is a safe and effective therapeutic technique for ICC. Acceptable survival can be achieved in primary ICCs, whereas the prognosis of recurrent ICCs is relatively poor.

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Figures

Figure 1
Figure 1
A 66-year-old female with intrahepatic cholangiocarcinoma (ICC). (a) The ICC (arrows), 3.1 cm in diameter, shows hyperenhancement during arterial phase on contrast-enhanced ultrasound before microwave ablation. (b) The nodule (arrows) shows non-enhancement on contrast-enhanced ultrasound 1 month after ablation, indicating a complete necrosis. (c) Contrast-enhanced CT 1 month after ablation demonstrates a uniform hypoattenuating area without enhancement (arrow), also indicating complete ablation.
Figure 2
Figure 2
Overall (cumulation) survival rates according to patient source in 18 patients who underwent percutaneous thermal ablation. There was significant difference between primary intrahepatic cholangiocarcinoma (ICC; green line) and recurrent ICC (blue line; p=0.001).
See this image and copyright information in PMC

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