!`*ii @@@ @@@@,W=ii EN DB i     & . 67 ]CYJQW pv|     '| Allegra1999 Allegra1999# Allegra2000 Allegra2001Allgaier20000 Ambrosi2000Andreola19988 Aoyama19999 Asano1999 Ayuso2001 Bartolozzi2000 Berber20000 Berber20000 Bertolini2001 Bertolini2001 Bianchi2001 Bianchi2001 Bianchi2001 Bilchik1999 Bilchik1999# Bilchik2000 Bilchik2001 Blum2000o Boige2000 Boix20012 Bostick1999 Bostick1999 Bru2001 Bruix2001 Bruno2001 Buckley1999 Buczkowski1999' Burgoa20011 Buscarini1996 Buscarini1996 Buscarini1998 Buscarini1998* Chao20010& Christians2001 Chung1999# Chung2000 Compton2000' Coppa2001$ Cova2001 Cremona1999 Curley1999: Curley2000: Curley2000: Curley2001: Daniele1999de Baere2000 de Baere20000  Del Maschio1997 Dellanoce1999$ Dellanoce2001 Delrio1999:Di Stasi1996Di Stasi19989 Din2000 Dodd20010 Dromain2000 Ducreux2000  Duvillard2000E1995E1995* Edwards2001  El Otmany2000 Elias2000  Elias2000 Ellis1999 Ellis2000 Engle2000 Engle2000F1995' Fabbri20011 Fiocca19979 Fiore1999& Foley2001 Fornari2000 Foroutani2000 Foroutani2000 Foshag19999# Foshag20000 Ganau2001 Garbagnati1996 Garbagnati1998 Garbagnati2000' Garbagnati2001 Garland2000 Garland2000 Gazelle1997 Gazelle1998 Gazelle1999 Gazelle1999  Gazelle2000 Gazelle2000 Gazelle2000 Gazelle2000$ Gazelle2001 Goharin2000 Goldberg1997 Goldberg1998Goldberg1999Goldberg1999 Goldberg2000 Goldberg2000 Goldberg2000Goldberg2000$Goldberg2001 Granchi1999H1993 Habib1999 Hahn19989$ Halpern2001 Hansen1999Hasegawa19999 Havlik1999"Hironaka20010 Ho1999 Hsueh1999 Ierace19979 Ierace19999 Ierace20000$ Ierace20010 Ituarte2000 Izzo19999 Izzo20000 Izzo20000 Jiao1999 JM1993 JP1993 July1999i Kainuma1999% Kato(12001Kenmochi19999 Kuoch2000"Kurokawa2001" Kusano20012L1995L1995 Lassau20000 Lasser20000 Lasser20000 Lazzaroni1999 Lazzaroni2000 Lee1999Lencioni20000 Livraghi1997 Livraghi1998Livraghi1999Livraghi19999 Livraghi2000Livraghi2000$Livraghi2001 Llovet2001M1995 Marchiano2000' Marchiano2001 Marteau2000 Mazzaferro2000' Mazzaferro2001 McGahan2001* McMasters2001 Meloni19999 Meloni20000$ Meloni20010 Mitry1999Montorsi2001Montorsi2001 Morton19999 Mueller1997 Mueller1998 Mueller2000 Mueller2000 Nakagohri1999 Nicolas2000 Ochiai19999" Okita2001 Opocher2001 Opocher2001 Owen19999P1993P1995 Pages2001 Paties19961 Patterson1999 Pignata1999 Pignatelli1999& Pitt20011 Podda2001 Podda2001' Pulvirenti2001Quaretti19966Quaretti19989Quaretti20000& Quebbeman2001& Quiroz20012 Rago19981%Reddy(2)2001' Regalia2001 Rizzatto1997 Roche2000 Rodes2001 Rogers20000 Rogers20000' Romito20010 Rose19999 Rose1999# Rose2000 Rossi1996 Rossi1998 Rossi2000 Ryan2000 Ryan20000S1995 Sala20011Salmeron2001 Santambrogio2001 Santambrogio2001Sasagawa19999! Schell20011' Schiavo2001 Scudamore1999 Servadio1997" Shirahashi2001 Silverman1996 Silverman1998* Simpson2001 Siperstein2000 Siperstein2000 Sironi19979 Solbiati1997 Solbiati1998Solbiati19999Solbiati1999 Solbiati2000Solbiati20000$Solbiati2001 Sole20011 Squassante1996 String20000 String20000 Tagliaferri2001 Taieb2000Takayama1999 Tanabe19989 Tanabe20000 Tokoro19999 Tolla2000 Vallone1999 Vallone2000 Vilana2001& Wallace2001! Wessels2001* Wong2001# Wood2000 Wood20010"Yamasaki2001 Zangrandi1998 Zuin20010 Zuin2001r0010 Zuin2001r Zuin2001r Zuin2001r10 Zuin2001r20010 Zuin2001r10 Zuin2001r20010 Zuin2001r10 Zuin2001r10 Zuin2001r10 Zuin2001r10 Zuin2001r0010 Zuin2001r Zuin2001r10 Zuin2001r20010 Zuin2001r20010 Zuin2001r   "!$#% AuthorsJournals Keywords                                i  d Allegra, D.P.Allgaier, H.P. Ambrosi, C. Andreola, S. Aoyama, H. Asano, T. Ayuso, C.Bartolozzi, C. Berber, E. Bertolini, E. Bianchi, L. Bianchi, P. Bilchik, A.J. Blum, H.E. Boige, V. Boix, L. Bostick, P.J. Bru, C. Bruix, J. Bruno, S. Buckley, A.R.Buczkowski, A.K. Burgoa, L. Buscarini, E. Buscarini, L. Chao, C.Christians, K. K. Chung, M. Chung, S.W. Compton, C.C. Coppa, J. Cova, Luca Cremona, F. Curley, S.A. Daniele, B. de Baere, T.Del Maschio, A. Dellanoce, M.Dellanoce, Marina Delrio, P. Di Stasi, M. Din, M.G.Dodd, G.D., III Dromain, C. Ducreux, M. Duvillard, P. E, Buscarini E, SquassanteEdwards, M. J. El Otmany, A. Elias, D. Ellis, L.M. Engle, K. F, Garbagnati Fabbri, A. Fiocca, R. Fiore, F. Foley, W. D. Fornari, F. Foroutani, A. Foshag, L.J. Ganau, S.Garbagnati, F. Garland, A.Gazelle, G. Scott Gazelle, G.S. Goharin, A.Goldberg, S. NahumGoldberg, S.N. Granchi, J. H, Tesluk Habib, N. Hahn, P.F.Halpern, Elkan F. Hansen, P.D. Hasegawa, M. Havlik, R. Hironaka, K. Ho, S.G. Hsueh, E. Ierace, T.Ierace, Tiziana Ituarte, P. Izzo, F. Jiao, L.R. JM, Brock JP, McGahan July, L.V. Kainuma, O.Kato(1, 3), Tomoaki Kenmochi, T. Kuoch, V. Kurokawa, F. Kusano, N. L, Buscarini L, Cavanna Lassau, N. Lasser, P. Lazzaroni, S. Lee, S.I. Lencioni, R. Livraghi, T.Livraghi, Tito Llovet, J.M. M, Di Stasi Marchiano, A. Marteau, V.Mazzaferro, V. McGahan, J.P.McMasters, K. M. Meloni, F.Meloni, Franca Mitry, R.R. Montorsi, M. Morton, D.L. Mueller, P.R. Nagy, A.G. Nakagohri, T.Nicolas, Vauthey J. Ochiai, T. Okita, K. Opocher, E. Owen, D.A. P, Quaretti P, Schneider Pages, M. Paties, C.T.Patterson, E.J. Pignata, S.Pignatelli, M. Pitt, H. A. Podda, M.Pulvirenti, A. Quaretti, P.Quebbeman, E. J. Quiroz, F. A. Rago, M. Reddy(2), K. Regalia, E. Rizzatto, G. Roche, A. Rodes, J. Rogers, S. Romito, R. Rose, D.M. Rossi, S. Ryan, T. S, Rossi Sala, M.Salmeron, J.M.Santambrogio, R. Sasagawa, S. Schell, S.R. Schiavo, M.Scudamore, C.H. Servadio, G.Shirahashi, H. Silverman, D.Silverman, D.E. Simpson, D.Siperstein, A. Sironi, S. Solbiati, L.Solbiati, Luigi Sole, M.Squassante, L. String, A.Tagliaferri, B. Taieb, J. Takayama, W. Tanabe, K.K. Tokoro, Y. Tolla, G.D. Vallone, P. Vilana, R.Wallace, J. R. Wessels, F.J. Wong, S. L. Wood, T.F. Yamasaki, T. Zangrandi, A. Zuin, M.  AJR Am.J.Roentgenol.(%AJR.American Journal of Roentgenology Am.J.Surg. Am.Surg. American Journal of Surgery Ann.Surg.Ann.Surg.Oncol.Annals of Surgery Cancer,'Cancer Journal From Scientific American_(%European Journal of Surgical OncologyHepatogastroenterology Hepatology J.Surg.Res.(#Journal of Gastrointestinal Surgery Oncologist Radiology($Seminars in interventional radiology Surg.Endosc.0+The Cancer Journal from Scientific American Transplantation Proceedings   h0+*Antineoplastic Agents/tu [Therapeutic Use],'*Carcinoma, Hepatocellular/su [Surgery],&*Carcinoma,Hepatocellular/su [Surgery]nl,&*Carcinoma,Hepatocellular/th [Therapy]*Catheter Ablation$*Catheter Ablation/mt [Methods]er($*Colorectal Neoplasms/pa [Pathology]*Contrast Media *Diathermy*Electrocoagulation,(*Electrocoagulation/is [Instrumentation]$ *Electrocoagulation/mt [Methods] *Ethanol/tu [Therapeutic Use]*Hyperthermia,Induced0**Hyperthermia,Induced/is [Instrumentation]("*Hyperthermia,Induced/mt [Methods] *Liver Cirrhosis/th [Therapy]$!*Liver Neoplasms/ra [Radiography]$*Liver Neoplasms/sc [Secondary] *Liver Neoplasms/su [Surgery] *Liver Neoplasms/th [Therapy](%*Liver Neoplasms/us [Ultrasonography]*Liver Transplantation*Liver/bs [Blood Supply]0**Magnetic Resonance Imaging/st [Standards] *Needles$*Neoplasm Staging/mt [Methods]*Neoplasms/th [Therapy]$*Preoperative Care/mt [Methods]$!*Radio Waves/tu [Therapeutic Use]0**Tomography, X-Ray Computed/st [Standards]$*Ultrasonography,Interventional84*Ultrasonography,Interventional/is [Instrumentation]0 (Antineoplastic Agents)0 (Contrast Media) 0 (Gelatin Sponge,Absorbable)0 (Polysaccharides)$0 (Saline Solution,Hypertonic)127279-08-7 (SHU 508)64-17-5 (Ethanol) 80529-93-7 (Gadolinium DTPA)Adenocarcinomaadministration & dosageAdultadverse effectsAgedtAged,80 and over[ Algorithmspla analysis Angiography Animale e$Antimetabolites,AntineoplasticBalloon DilatationBalloon OcclusionBias (Epidemiology) Biopsy,Needleblood blood supplyBurnsCarcinoembryonic AntigenuCarcinoid TumorCarcinoma,Hepatocellular0*Carcinoma,Hepatocellular/bs [Blood Supply],'Carcinoma,Hepatocellular/di [Diagnosis]0*Carcinoma,Hepatocellular/dt [Drug Therapy],'Carcinoma,Hepatocellular/mo [Mortality],'Carcinoma,Hepatocellular/pa [Pathology]l,)Carcinoma,Hepatocellular/ra [Radiography],'Carcinoma,Hepatocellular/sc [Secondary]l0-Carcinoma,Hepatocellular/us [Ultrasonography]Carcinoma,NeuroendocrineCatheter Ablation,&Catheter Ablation/ae [Adverse Effects]nl,&Catheter Ablation/is [Instrumentation]nl$Catheter Ablation/mt [Methods] Catheter Ablation/td [Trends] Cell Death Chemoembolization,TherapeuticChild Cholecystitis/et [Etiology]Cohort StudiesColorectal Neoplasmsu(#Colorectal Neoplasms/pa [Pathology]Combined Modality TherapyComparative Study complicationsConscious SedationContrast Media Cryosurgeryyo diagnosis Diaphragm$Diathermy/is [Instrumentation]]Disease-Free Survival$Dose-Response Relationship,Drug Drainage Drug Administration Schedule drug therapyElectrocoagulation,'Electrocoagulation/is [Instrumentation]$Electrocoagulation/mt [Methods] ElectrodesblaEquipment Designs Ethanol($Ethanol/ad [Administration & Dosage]     "!!#$#% TxhbRadiofrequency ablation: a minimally invasive technique with multiple applications. [see comments]LEBilchik,A.J. Rose,D.M. Allegra,D.P. Bostick,P.J. Hsueh,E. Morton,D.L.2 199911/19999vp*Electrocoagulation *Liver Neoplasms/su [Surgery] *Radio Waves/tu [Therapeutic Use] Adult Aged Aged,80 and over Carcinoembryonic Antigen Cryosurgery Female Human Laparoscopy Liver Liver Neoplasms/ra [Radiography] Liver Neoplasms/us [Ultrasonography] Male Melanoma methods Middle Age Morbidity Temperature therapy Tomography,X-Ray Computed Ultrasonography United States356-361.'Cancer Journal From Scientific Americans5n6Lseries of 50 patients with mixed population of tumors; 13 perc, 21 lap with lap US, 16 open with IOUS; 6 month FU 27 disease free, 17 alive with disease, 6 dead  j dPURPOSE: Radiofrequency ablation (RFA) of soft tissue, which has recently been approved by the United States Food and Drug Administration, destroys tumor cells by delivering an electrical current through a 15-gauge needle. This study evaluated RFA for patients with hepatic malignancies considered unresectable because of their distribution, their number, and/or the presence of liver dysfunction. PATIENTS AND METHODS: Between November 1997 and February 1999, 50 patients with 132 unresectable hepatic metastases underwent RFA of tumors from 0.5 to 9 cm in diameter. There were 41 colorectal metastases in 22 patients, 13 hepatomas in seven patients, 37 neuroendocrine metastases in six patients, and 41 noncolorectal metastases in 15 patients. Real-time ultrasonography was used to guide RFA, and lesions were ablated by applying temperatures of approximately 100 degrees C for 8 minutes. Overlapping ablations were used for larger lesions. In patients with multiple lesions, RFA was performed simultaneously with cryosurgery, resection, and/or hepatic arterial infusion. RESULTS: RFA was undertaken percutaneously on an outpatient basis in 13 patients (25 lesions). The remaining patients underwent RFA via laparoscopy (21 patients; 58 lesions) or celiotomy (16 patients; 49 lesions); mean hospital stay was 1 and 5 days, respectively. RFA was the sole therapy in 28 patients and was additional therapy in 22 patients. At a median follow-up of 6 months, 27 patients were free of disease, 17 were alive with disease, and six had died of their disease (three colon, three melanoma). Three patients whose disease recurred at a prior RFA site underwent successful percutaneous RFA. Overall, there was a significant postoperative reduction in levels of carcinoembryonic antigen, alpha-fetoprotein, serotonin, and 5-hydroxyindoleacetic acid. Intraoperative ultrasonography identified unrecognized hepatic lesions in 12 of 37 patients (32%); these lesions were successfully ablated. When performed with cryosurgery, RFA reduced the morbidity of multiple freezes. DISCUSSION: RFA is a safe and effective alternative for the ablation of unresectable hepatic malignancies and when used adjunctively can reduce the morbidity of cryosurgery. Percutaneous and laparoscopic RFA can be performed effectively with less than 24 hours of hospitalization. Intraoperative ultrasonography is essential for accurate stagingDB - MEDLINE UI - 20072493 IN - John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California 90404, USA CM - Comment in: Cancer J Sci Am. 1999 Nov-Dec;5(6):339-400 JC - cr8, CR8 Journal Subset Index Medicus CP - United States PT - Journal Article LG - English EM - 19991230 Revised: 20001218. Entry Week: 19991230 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 1081-4442,230 PM:10606477*#Bilchik,A.J. Wood,T.F. Allegra,D.P. 2001d]Radiofrequency ablation of unresectable hepatic malignancies: lessons learned. [see comments]  Oncologist6a1, 24-33i 2001^WReview of management of liver tumors at John Wyne Cancer Institute. Recommends HAI pump in all patients undergoing open resection or ablation. Resection 1st option, then RFA for <3cm and CSA for >3cm. IOUS used. Complication rate 8%. Nice figures. Unusual complications of late abcess (20months) and HA aneurysm. Notes lack of multiple probes.r14\U*Catheter Ablation/mt [Methods] *Liver Neoplasms/su [Surgery] Algorithms Catheter Ablation/ae [Adverse Effects] Catheter Ablation/is [Instrumentation] complications Human Laparoscopy/mt [Methods] Liver Liver Neoplasms/pa [Pathology] Neoplasm Recurrence,Local/su [Surgery] Patient Selection Support,Non-U.S.Gov't Ultrasonography United StatesRadiofrequency ablation (RFA) is increasingly used for the local destruction of unresectable hepatic malignancies. Relative contraindications include tumors in proximity to vital structures that may be injured by RFA and lesions whose size exceeds the ablation capabilities of the probe system employed. Given current technology, we believe that RFA should be cautiously utilized for lesions greater than 5 cm in diameter. Open (celiotomy) and laparoscopic approaches to RFA allow intraoperative ultrasonography, which may demonstrate occult hepatic disease. In addition, RFA performed via celiotomy can be accompanied by resection or cryosurgical ablation, and isolation of the liver from adjacent organs. Percutaneous RFA should be reserved for patients who cannot undergo general anesthesia, those with recurrent or progressive lesions, and those with smaller lesions sufficiently isolated from adjacent organs. Complications may be minimized when these approaches are selectively appliedlDB - MEDLINE UI - 21113048 IN - Department of Surgical Oncology, John Wayne Cancer Institute, Santa Monica, California 90404, USA. bilchika@jwci.org CM - Comment in: Oncologist. 2001;6(1):12-3 JC - dd5 Journal Subset Index Medicus CP - United States PT - Journal Article LG - English EM - 20010329. Entry Week: 20010329 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 1083-7159D>http://theoncologist.alphamedpress.org/cgi/content/full/6/1/24 |Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies: results in 123 patients. [see comments]nhCurley,S.A. Izzo,F. Delrio,P. Ellis,L.M. Granchi,J. Vallone,P. Fiore,F. Pignata,S. Daniele,B. Cremona,F. 1999 7/1999>8*Diathermy *Liver Neoplasms/sc [Secondary] *Liver Neoplasms/th [Therapy] Adult Aged Aged,80 and over complications Diathermy/is [Instrumentation] Electrodes Equipment Design Female Follow-Up Studies Heat Human Liver Male methods Middle Age Needles Prospective Studies Recurrence Risk Safety surgery United States 1-8Annals of Surgery 2301123 patients with 169 tumors. 31 perc, 92 open with Pringle. Complication rate 2.4%. 15 month FU with 1.8% local recurrence and 27.6 recurrence at other siteszsOBJECTIVE: To describe the safety and efficacy of radiofrequency ablation (RFA) to treat unresectable malignant hepatic tumors in 123 patients. BACKGROUND: The majority of patients with primary or metastatic malignancies confined to the liver are not candidates for resection because of tumor size, location, or multifocality or inadequate functional hepatic reserve. Local application of heat is tumoricidal; therefore, the authors investigated a novel RFA system to treat patients with unresectable hepatic cancer. PATIENTS AND METHODS: Patients with hepatic malignancies were entered into a prospective, nonrandomized trial. The liver tumors were treated percutaneously or during surgery under ultrasound guidance using a novel LeVeen monopolar array needle electrode and an RF 2000 generator. All patients were followed to assess complications, treatment response, and recurrence of malignant disease. RESULTS: RFA was used to treat 169 tumors (median diameter 3.4 cm, range 0.5 to 12 cm) in 123 patients. Primary liver cancer was treated in 48 patients (39.1%), and metastatic liver tumors were treated in 75 patients (60.9%). Percutaneous and intraoperative RFA was performed in 31 patients (35.2%) and 92 patients (74.8%), respectively. There were no treatment-related deaths, and the complication rate after RFA was 2.4%. All treated tumors were completely necrotic on imaging studies after completion of RFA treatments. With a median follow-up of 15 months, tumor has recurred in 3 of 169 treated lesions (1.8%), but metastatic disease has developed at other sites in 34 patients (27.6%). CONCLUSIONS: RFA is a safe, well-tolerated, and effective treatment to achieve tumor destruction in patients with unresectable hepatic malignancies. Because patients are at risk for the development of new metastatic disease after RFA, multimodality treatment approaches that include RFA should be investigatedDB - MEDLINE UI - 99325616 IN - Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA CM - Comment in: Ann Surg. 1999 Jul;230(1):9-11 JC - 67s, 67S, 0372354 Journal Subset AIM Journals CP - United States PT - Clinical Trial PT - Journal Article LG - English EM - 19990805 Revised: 20001218. Entry Week: 19990805 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0003-4932,527 PM:10400029 eter Ablation *Liver Neoplasms/th [Therapy]56VORadiofrequency ablation of hepatocellular cancer in 110 patients with cirrhosis B4.0 cm). 45.5% additional disease. 50.9% disease-free. 12.7% complication (4 ascites, 3 pleural effusions/hydropneumothorax, 1 Vfib, 1 fever, 4 bleed (1 transfusion and embolization, 1 re-op), 1 jaundice). 0% death.d^OBJECTIVE: To determine the treatment efficacy, safety, local tumor control, and complications related to radiofrequency ablation (RFA) in patients with cirrhosis and unresectable hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA: Most patients with HCC are not candidates for resection because of tumor size, location, or hepatic dysfunction related to cirrhosis. RFA is a technique that permits in situ destruction of tumors by means of local tissue heating. METHODS: One hundred ten patients with cirrhosis and HCC (Child class A, 50; B, 31; C, 29) were treated during a prospective study using RFA. Patients were treated with RFA using an open laparotomy, laparoscopic, or percutaneous approach with ultrasound guidance to place the RF needle electrode into the hepatic tumors. All patients were followed up at regular intervals to detect treatment-related complications or recurrence of disease. RESULTS: All 110 patients were followed up for at least 12 months after RFA (median follow-up 19 months). Percutaneous or intraoperative RFA was performed in 76 (69%) and 34 patients (31%), respectively. A total of 149 discrete HCC tumor nodules were treated with RFA. The median diameter of tumors treated percutaneously (2.8 cm) was smaller than that of lesions treated during laparotomy (4.6 cm). Local tumor recurrence at the RFA site developed in four patients (3.6%); recurrent HCC subsequently developed in other areas of the liver in all four. New liver tumors or extrahepatic metastases developed in 50 patients (45. 5%), but 56 patients (50.9%) had no evidence of recurrence. There were no treatment-related deaths, but complications developed in 14 patients (12.7%) after RFA. CONCLUSIONS: In patients with cirrhosis and HCC, RFA produces effective local control of disease in a significant proportion of patients and can be performed safely with minimal complicationsDB - MEDLINE UI - 20429923 IN - Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA. scurley@mdanderson.org JC - 67s, 67S, 0372354 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 20000919 Revised: 20001218. Entry Week: 20000919 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0003-4932 inoma,Hepatocellular/su [Surgery]$*Catheter Ablation/mt [Methods] Curley,S.A.. 2001\URadiofrequency ablation of malignant liver tumors. [see comments]. [Review] [47 refs]e Oncologist6p1i 14-23 2001Review of Curley's technique. Does not treat lesions >6cm or #>5-6 except palliation. Does not treat hilar plate to avoid injury to bile ducts.m15*Carcinoma,Hepatocellular/su [Surgery] *Catheter Ablation/mt [Methods] *Liver Neoplasms/su [Surgery] blood Carcinoma,Hepatocellular/pa [Pathology] Carcinoma,Hepatocellular/sc [Secondary] Catheter Ablation/ae [Adverse Effects] Catheter Ablation/is [Instrumentation] Electrodes Human Laparoscopy Laparotomy Liver Liver Neoplasms/pa [Pathology] Liver Neoplasms/sc [Secondary] Necrosis Support,Non-U.S.Gov't Ultrasonography Ultrasonography,Interventional United StatesPJThe majority of patients with primary or metastatic hepatic tumors are not candidates for resection because of tumor size, location near major intrahepatic blood vessels precluding a margin-negative resection, multifocality, or inadequate hepatic function related to coexistent cirrhosis. Radiofrequency ablation (RFA) is an evolving technology being used to treat patients with unresectable primary and metastatic hepatic cancers. RFA produces coagulative necrosis of tumor through local tissue heating. Liver tumors are treated percutaneously, laparoscopically, or during laparotomy using ultrasonography to identify tumors and guide placement of the RFA needle electrode. For tumors smaller than 2.0 cm in diameter, one or two deployments of the monopolar multiple array needle electrode are sufficient to produce complete coagulative necrosis of the tumor. However, with increasing size of the tumor, there is a concomitant increase in the number of deployments of the needle electrode and the overall time necessary to produce complete coagulative necrosis of the tumor. In general, RFA is a safe, well-tolerated, effective treatment for unresectable hepatic malignancies less than 6.0 cm in diameter. Effective treatment of larger tumors awaits the development of more powerful, larger array monopolar and bipolar RFA technologies. [References: 47]DB - MEDLINE UI - 21113047 IN - Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030-4095, USA. scurley@notes.mdacc.tmc.edu CM - Comment in: Oncologist. 2001;6(1):12-3 JC - dd5 Journal Subset Index Medicus CP - United States PT - Journal Article PT - Review PT - Review, Tutorial LG - English EM - 20010329. Entry Week: 20010329 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 1083-7159D>http://theoncologist.alphamedpress.org/cgi/content/full/6/1/14 @@ '"*!&$'%#   FAgedCatheter AblationColorectal Neoplasms complications Electrodes"Laparoscopic radiofrequency Curley,S.A. Izzo,F.r 2000 3/2000Adenocarcinoma Carcinoma,Neuroendocrine Catheter Ablation Human Laparoscopy Liver Neoplasms methods Neoplasm Recurrence,Local surgery United StatesUI - 20222419 LA - eng PT - Comment PT - Editorial DA - 20000511 IS - 1068-9265 SB - IM CY - UNITED STATES JC - B9R RefMgr field[1]: Journal RefMgr field[8]: Not in File 78-79Ann.Surg.Oncol.72b\Editorial. Rate of recurrence now up to 9% from 2%. 80% of local recurrences in tumors>6cm83 PM:10761782 `  529,TNHepatocellular carcinoma: radio-frequency ablation of medium and large lesionsZSLivraghi,T. Goldberg,S.N. Lazzaroni,S. Meloni,F. Ierace,T. Solbiati,L. Gazelle,G.S.R 2000 3/2000LE*Carcinoma,Hepatocellular/th [Therapy] *Hyperthermia,Induced/is [Instrumentation] *Liver Neoplasms/th [Therapy] *Ultrasonography,Interventional/is [Instrumentation] Aged Aged,80 and over Carcinoma,Hepatocellular/us [Ultrasonography] complications Conscious Sedation Equipment Design Female Hemorrhage Hepatitis B,Chronic/th [Therapy] Hepatitis B,Chronic/us [Ultrasonography] Human Laparotomy Liver Cirrhosis/th [Therapy] Liver Cirrhosis/us [Ultrasonography] Liver Neoplasms/us [Ultrasonography] Male methods Middle Age Necrosis Support,Non-U.S.Gov't Treatment Outcome United States761-768 Radiology 214380 patients with HCC between 3 and 5cm, 46 between 5 and 9.6cm. Percutaneous, cooled tip. Complete 47%, Near-complete 31%, partial 20%. 1 death (sepsis) and 1 major hemorrhage. Greater success in non-infiltrating and in smaller tumors.PIPURPOSE: To study local therapeutic efficacy, side effects, and complications of radio-frequency (RF) ablation in the treatment of medium and large hepatocellular carcinoma (HCC) lesions in patients with cirrhosis or chronic hepatitis. MATERIALS AND METHODS: One-hundred fourteen patients who were under conscious sedation or general anesthesia had 126 HCCs greater than 3.0 cm in diameter treated with RF by using an internally cooled electrode. Eighty tumors were medium (3.1-5.0 cm), and 46 were large (5.1-9.5 cm). The mean diameter for all tumors was 5.4 cm. At imaging, 75 tumors were considered noninfiltrating, and 51 were considered infiltrating. RESULTS: Complete necrosis was attained in 60 lesions (47.6%), nearly complete (90%-99%) necrosis in 40 lesions (31.7%), and partial (50%-89%) necrosis in the remaining 26 lesions (20.6%). Medium and/or noninfiltrating tumors were treated successfully significantly more often than large and/or infiltrating tumors. Two major complications (death, hemorrhage requiring laparotomy) and five minor complications (self-limited hemorrhage, persistent pain) were observed. The single death was due to a break in sterile technique rather than to the RF procedure itself. CONCLUSION: RF ablation appears to be an effective, safe, and relatively simple procedure for the treatment of medium and large HCCsf_DB - MEDLINE UI - 20184933 IN - Department of Radiology, Ospedale Civile, Vimercate, Italy. lalivra@tin.it JC - qsh, QSH, QSH, 0401260 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 20000329 Revised: 20001218. Entry Week: 20000329 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0033-8419zLlovet,J.M. Vilana,R. Bru,C. Bianchi,L. Salmeron,J.M. Boix,L. Ganau,S. Sala,M. Pages,M. Ayuso,C. Sole,M. Rodes,J. Bruix,J. 2001tnIncreased risk of tumor seeding after percutaneous radiofrequency ablation for single hepatocellular carcinoma Hepatology335 1124-1129 5/200132 pts with HCC. 11 major complications involved 7 patients: needle-track seeding (4), subcapsular hematoma (4), portal thrombosis (1), hemoperitoneum (1), and bleeding esophageal varices(1). Five minor complications: moderate to severe pain requiring major analgesia (3) and fever 38C unrelated to infection (2). 3 variables significantly associated with seeding: subcapsular location (P = .009), poor differentiation degree (P = .02), and baseline AFP levels (P = .02).174 PM:11343240XRblood complications Ethanol Hepatitis C Liver Morbidity Risk therapy United States Radiofrequency (RF) ablation is an alternative to percutaneous ethanol injection (PEI) for single nonsurgical hepatocellular carcinoma (HCC) and is currently used as adjuvant therapy before liver transplantation. This phase II study assesses the treatment-related complications and response rate of RF for the treatment of single HCC Tumor ablation with radio-frequency energy. [Review] [91 refs] Radiology1 217n3c633-646g12/2000BtnNice general review of technology and case series. States current limitation is current density. Notes bipolar39*Carcinoma,Hepatocellular/su [Surgery] *Catheter Ablation/mt [Methods] *Liver Neoplasms/su [Surgery] 0 (Saline Solution,Hypertonic) analysis Animal Carcinoma,Hepatocellular/sc [Secondary] Catheter Ablation/is [Instrumentation] Catheter Ablation/td [Trends] Electrodes Forecasting Human Kidney Liver Liver Neoplasms/pa [Pathology] Lung Necrosis Neoplasms/pa [Pathology] Neoplasms/su [Surgery] Saline Solution,Hypertonic/ad [Administration & Dosage] secondary United States NeoplasmseHATumor ablation by using radio-frequency energy has begun to receive increased attention as an effective minimally invasive approach for the treatment of patients with a variety of primary and secondary malignant neoplasms. To date, these techniques have been used to treat tumors located in the brain, musculoskeletal system, thyroid and parathyroid glands, pancreas, kidney, lung, and breast; however, liver tumor ablation has received the greatest attention and has been the subject of a large number of published reports. In this article, the authors review the technical developments and early laboratory results obtained with radio-frequency ablation techniques, describe some of the early clinical applications of these techniques, and conclude with a discussion of challenges and opportunities for the future. [References: 91]DB - MEDLINE UI - 20564684 IN - Decision Analysis and Technology Assessment Group, Department of Radiology, Massachusetts General Hospital, Zero Emerson Pl, Ste 2H, Boston, MA 02114, USA. gazelle@nmr.mgh.harvard.edu JC - qsh, QSH, QSH, 0401260 Journal Subset AIM Journals CP - United States PT - Journal Article PT - Review PT - Review, Academic LG - English EM - 20010111. Entry Week: 20010111 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0033-8419>8http://radiology.rsnajnls.org/cgi/content/full/217/3/633 Carcinoembryonic AntigenCarcinoma,HepatocellularCatheter AblationColorectal Neoplasms 545,<6Ablation of liver tumors using percutaneous RF therapy\UGoldberg,S.N. Gazelle,G.S. Solbiati,L. Livraghi,T. Tanabe,K.K. Hahn,P.F. Mueller,P.R.s 1998 4/1998 *Electrocoagulation *Liver Neoplasms/su [Surgery] Adult Aged Female Human Liver Liver Neoplasms/di [Diagnosis] Liver Neoplasms/ra [Radiography] Magnetic Resonance Imaging Male Middle Age Punctures Support,Non-U.S.Gov't therapy Tomography,X-Ray Computed United States 1023-1028,%AJR.American Journal of Roentgenology 17040)Percutaneous cooled-tip. Descriptive only{DB - MEDLINE UI - 98191084 IN - Department of Radiology, Massachusetts General Hospital, Harvard School of Medicine, Boston 02114, USA JC - 3ae, 3AE, 3AE, 7708173 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 19980416 Revised: 20001218. Entry Week: 19980416 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0361-803X  ion & dosageAdultAgedjdTreatment of intrahepatic malignancy with radiofrequency ablation: radiologic-pathologic correlationF@Goldberg,S.N. Gazelle,G.S. Compton,C.C. Mueller,P.R. Tanabe,K.K. 20006/1/2000@9Aged analysis Carcinoma,Hepatocellular Colorectal Neoplasms Electrocoagulation Electrodes Human injuries Linear Models Liver Liver Neoplasms Magnetic Resonance Imaging Male methods Middle Age Necrosis pathology secondary Support,Non-U.S.Gov't therapy Tomography,X-Ray Computed Ultrasonography United States Safety-UI - 20320720 LA - eng PT - Journal Article DA - 20000911 IS - 0008-543X SB - AIM SB - IM CY - UNITED STATES JC - CLZ RefMgr field[1]: Journal RefMgr field[8]: Not in File' 2452-2463t Cancer881122 patients underwent cooled-tip RF followed by resection. Single RF lesion, did not attempt multiple lesions to increase lesion size. Residual tumor in 6 tumors by CT. Histo: only 6 tumors treated completely by gross exam. There were 2 tumors treated percutaneously in which lesion did not match tumor site. Larger lesions with intra-op Pringle. At 3-7 days post-ablation, coagulation necrosis was seen. Small islands of "electrocautery-affected" cells in 3 tumors. 11 tumors excised immediately: 8 examined with immuno for Lactate dehydrogenase activity, 4 with 2,3,5-triphenyltetrazolium chloride for mitochondrial activity. All had no activity within treated zone but activity present in untreated tumor.BACKGROUND: Radiofrequency (RF)-induced tissue coagulation represents a new approach for the thermal destruction of tumors within the liver. The purpose of the current study was to 1) assess technique safety; 2) determine the extent and evolution of induced cellular damage; and 3) correlate the observed pathologic effects with radiologic studies. METHODS: Twenty-three tumors measuring 3 days after ablation showed definite, contiguous coagulative necrosis without intervening areas of viable tumor. CT and MRI scans demonstrated circumscribed hypodense, nonenhancing regions surrounding the electrode tract as early as 15 minutes after ablation. These corresponded within 2 mm to measurements of coagulation at pathology. CONCLUSIONS: RF ablation is a minimally invasive and safe approach to the treatment of tumors in the liver. Tumors treated with RF energy do not immediately demonstrate coagulative necrosis, but do show evidence of irreversible cellular damage. The extent of tumor necrosis correlates closely with findings at contrast-enhanced imaging'piDepartment of Radiology, Massachusettseneral Hospital, Harvard Medical School, Boston, Massachusetts, USA71 PM:10861420 530,Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, techniques, and diagnostic imaging guidance. [see comments]. [Review] [67 refs]n.'Goldberg,S.N. Gazelle,G.S. Mueller,P.R.0 2000 2/2000*Hyperthermia,Induced/mt [Methods] *Neoplasms/th [Therapy] Follow-Up Studies Human Magnetic Resonance Imaging Neoplasms/di [Diagnosis] therapy Tomography,X-Ray Computed United States323-3318,%AJR.American Journal of Roentgenology 1742DB - MEDLINE UI - 20121786 IN - Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA CM - Comment in: AJR Am J Roentgenol. 2000 Feb;174(2):287 JC - 3ae, 3AE, 3AE, 7708173 Journal Subset AIM Journals CP - United States PT - Journal Article PT - Review PT - Review, Tutorial LG - English EM - 20000217 Revised: 20001218. Entry Week: 20000217 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0361-803Xinoma,Hepatocellular/th [Therapy]0**Hyperthermia,Induced/is b\Clinical short-term results of radiofrequency ablation in primary and secondary liver tumorsHAJiao,L.R. Hansen,P.D. Havlik,R. Mitry,R.R. Pignatelli,M. Habib,N.  1999 4/1999jcblood Carcinoembryonic Antigen Carcinoma,Hepatocellular Catheter Ablation Colorectal Neoplasms Female Heat Human Liver Liver Neoplasms Male methods Middle Age Neoplasm Recurrence,Local pathology Postoperative Complications Radiology,Interventional Recurrence secondary secretion surgery Surgical Procedures,Operative Treatment Outcome United States Europe[UI - 99256780 LA - eng RN - 0 (Carcinoembryonic Antigen) PT - Clinical Trial PT - Journal Article DA - 19990525 IS - 0002-9610 SB - AIM SB - IM CY - UNITED STATES JC - 3Z4 RefMgr field[1]: Journal RefMgr field[8]: Not in File 303-306 Am.J.Surg. 177435 patient preliminary case series. Human percutaneous/intraop together, 11% recurrence, some synchronous with resection- advocate combining the two for bilobar disease ^ XBACKGROUND: Radiofrequency ablation (RFA) is emerging as a new therapeutic method for management of solid tumors. We report here our experience in the use of this technique for management of primary and secondary unresectable liver cancers. METHODS: Thirty-five patients with liver cancers were considered not suitable for curative resection at presentation: 8 with primary hepatocellular carcinoma ([HCC] 6 HCC and 2 fibrolamellar); 27 with metastatic liver cancer (17 colorectal carcinoma and 10 others). They were treated either with radiofrequency heat ablation (Radionics Europe N.V., Wettdren, Belgium) alone percutaneously and/or intraoperatively or in conjunction with surgical resections. The quality of RFA was based on the subjective feeling of whether the tumor was completely destroyed or not. The effectiveness of RFA was assessed according to clinical findings, radiographic images, and tumor markers at follow-up. RESULTS: In 8 primary liver cases, 4 patients with a high level of alpha fetoprotein (AFP) benefited from the RFA with a 83.3% to 99.7% reduction of AFP. One with fibrolamellar hepatocellular carcinoma died 2 months after an incomplete percutaneous RFA from recurrence. The rest all had stable disease at the time of follow-up (mean 10.4 months). In patients with colorectal liver metastases, there were 4 deaths: 1 patient died postoperatively on the 30th day from a severe chest infection having shown a considerable reduction of carcinoembryonic antigen level (CEA, 8 versus 36 microg/L); 3 died from local and systemic disease, 1 at 12 months and 2 at 1 month, having had an incomplete RFA. The others had stable disease at follow-up (mean 7.6 months). Five patients underwent liver resections successfully with the application of RFA for residual lesions in the remaining contralateral lobe. In 10 patients with other liver tumors, 7 patients had stable disease at follow-up (mean 13.4 months); 1 patient had evidence of local and systemic recurrence 10 months after surgical resections with the intraoperative RFA and 2 patients died of systemic recurrence of disease 3 and 6 months after RFA alone. Two patients had liver resections in conjunction with the intraoperative RFA. The mean follow-up in our series was 8.5 months. CONCLUSION: Radiofrequency heat ablation is useful as a primary treatment for unresectable liver cancers. The procedure can be used to treat the small residual tumor load in the contralateral lobe following liver resection in those considered unresectable at the first presentation. This new therapeutic strategy seems to increase surgical resectability in patients judged unresectable'|uLiver Surgery Section, Imperial College School of Medicine, The Hammersmith Hospital, London, England, United Kingdom172 PM:10326848 jstic Agents/tu [Therapeutic Use] 576NGTreatment of liver tumors by percutaneous radiofrequency electrocautery7.(McGahan JP Schneider P Brock JM Tesluk H 1993 1993 Liver<5RefMgr field[1]: Journal RefMgr field[8]: Not in Filer143-149-*$Seminars in interventional radiology10F?early description, us guided in pigs. Case report in 3 humans.sCombined therapy with radiofrequency thermal ablation and intra- arterial infusion chemotherapy for hepatic metastases from colorectal cancertnKainuma,O. Asano,T. Aoyama,H. Takayama,W. Nakagohri,T. Kenmochi,T. Hasegawa,M. Tokoro,Y. Sasagawa,S. Ochiai,T. 1999 3/1999administration & dosage Adult Aged Antimetabolites,Antineoplastic Colorectal Neoplasms Combined Modality Therapy complications Dose-Response Relationship,Drug Drug Administration Schedule drug therapy Female Fluorouracil Human Hyperthermia,Induced Infusions,Intra-Arterial Liver Liver Neoplasms Male Middle Age mortality Recurrence secondary surgery Survival Rate Temperature therapy Treatment OutcomeoUI - 99298807 LA - eng RN - 0 (Antimetabolites, Antineoplastic) RN - 51-21-8 (Fluorouracil) PT - Journal Article DA - 19990813 IS - 0172-6390 SB - IM CY - GREECE JC - GA7 RefMgr field[1]: Journal RefMgr field[8]: Not in File 1071-1077sHepatogastroenterology46269 patients with advanced colorectal metastatic disease. Combined RF and Hepatic artery infusion of chemoTx. 3/9 2year survival.s BACKGROUND/AIMS: In this preliminary study, we investigated the efficacy of combined radiofrequency thermal ablation therapy (RFA) with hepatic arterial infusion chemotherapy (HAI) in the treatment of multiple liver metastases from colorectal cancer. METHODOLOGY: Nine patients with bilobular multiple metastases was treated. The number of nodules was 6.0 +/- 3.9 (range: 2-13), and the size was 2.1 +/- 1.0 cm (range: 0.5-4.8 cm) in diameter. RFA was performed using a RF generator operating at 460 kHz with a 15-gauge, 4-prong custom RF needle. Treatment temperature was kept at 90-110 degrees C for 5 min. 5- Fluorouracil (5-FU) was administered by weekly 750-1250 mg/body/5 h as the regimen of HAI. RESULTS: During a 15.2-month follow-up period, 6 of 9 patients survived more than 1 year. Three of the 6 survived more than 2 years. Serum CEA level in 5 patients dropped from 24.5 +/- 9.5 ng/ml to 10.3 +/- 5.5 ng/ml. Local recurrence was observed in 5 patients and new lesions in 4. Extrahepatic recurrence was observed in 5 patients. There were no serious complications but one HAI-related cerebral thrombosis. CONCLUSIONS: Combined RFA with HAI would be effective and safe. This modality provides a new option for the treatment of multiple liver metastases from colorectal cancer'LFDepartment of Surgery (II), Chiba University School of Medicine, Japan119 PM:10370669 '}Pulvirenti, A. Garbagnati, F. Regalia, E. Coppa, J. Marchiano, A. Romito, R. Schiavo, M. Fabbri, A. Burgoa, L. Mazzaferro, V..ngExperience with radiofrequency ablation of small hepatocellular carcinomas before liver transplantationa"Transplantation Proceedingsr 200133 1-2a 1516-7*Carcinoma, Hepatocellular/su [Surgery] *Catheter Ablation Human Liver Cirrhosis/su [Surgery] *Liver Neoplasms/su [Surgery] *Liver Transplantation Middle Age Support, Non-U.S. Gov'tijcRadiofrequency ablation: a novel primary and adjunctive ablative technique for hepatic malignanciesB*Carcinoma,Hepatocellular/su [Surgery] *Electrocoagulation *Liver Neoplasms/su [Surgery] Aged Biopsy,Needle Carcinoma,Hepatocellular/di [Diagnosis] Carcinoma,Hepatocellular/mo [Mortality] Disease-Free Survival Electrocoagulation/is [Instrumentation] Electrocoagulation/mt [Methods] Female Follow-Up Studies Human Liver Neoplasms/di [Diagnosis] Liver Neoplasms/mo [Mortality] Liver Neoplasms/sc [Secondary] Liver/pa [Pathology] Male methods Necrosis Neoplasm Recurrence,Local Recurrence Support,Non-U.S.Gov't surgery Survival Rate Time Factors Treatment Outcome United States759-768,%AJR.American Journal of Roentgenology 1673pj5% local recurrence, 36% "new lesions" on mean f/u 22 months, some recurrence seen on resection specimens.OBJECTIVE: The aim of this study was to evaluate the usefulness of RF interstitial thermal ablation for treating hepatic cancer. SUBJECTS AND METHODS: Fifty patients, 39 who had 41 hepatocellular carcinoma nodules and 11 who had 13 hepatic metastatic nodules, underwent RF interstitial thermal ablation. In all but one, a thermal necrosis volume greater than the tumoral nodule volume was created to obtain total tumor destruction. One large tumor was treated for debulking purposes. RESULTS: Hepatocellular carcinoma nodule destruction was achieved in a mean of 3.3 sessions of RF interstitial thermal ablation. During a mean follow-up of 22.6 months (range, 3-66 months), 16 (41%) of 39 patients had recurrences; two (5%) of these patients showed local recurrences and the remaining 14 (36%) had new lesions. Nine of these 16 patients underwent further RF interstitial thermal ablation that proved effective. RF interstitial thermal ablation was also successfully repeated in four patients who had a second recurrence. With RF interstitial thermal ablation, we treated 54 hepatocellular carcinoma nodules in 39 patients. Eleven (28%) of the 39 patients died: five from hepatic failure due to advanced cancer and six from causes other than cancer. Autopsy was performed on three patients who died from causes other than cancer, one had had two new courses of RF interstitial thermal ablation for two new lesions. Gross examination failed to detect two treated tumor nodules; histologic examination of three other treated tumor nodules showed total necrosis in two nodules and a 3-mm focus of viable cancer cells in the other nodule. Cumulative survival curves showed the median survival time to be 44 months. The survival rate for the first year was 0.94, 0.86 for the second year, 0.68 for the third year, and 0.40 for the fourth and fifth years. In the patients treated for metastatic nodules, posttreatment imaging studies showed necrosis that varied from 80% to 100% in all cases. Pathologic studies performed on two patients who underwent surgery after RF interstitial thermal ablation showed 100% necrosis in one case and 80% necrosis in the other. CONCLUSION: RF interstitial thermal ablation is a useful percutaneous treatment for hepatic cancerRLDB - MEDLINE UI - 96350050 IN - Department of Gastroenterology, Hospital of Piacenza, Italy JC - 3ae, 3AE, 3AE, 7708173 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 199610 Revised: 20001218. Entry Week: 199610 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0361-803X~Radiofrequency interstitial thermal ablation of hepatocellular carcinoma in liver cirrhosis. Role of the laparoscopic approach^XMontorsi,M. Santambrogio,R. Bianchi,P. Opocher,E. Zuin,M. Bertolini,E. Bruno,S. Podda,M. 2001 2/2001RLLiver Liver Cirrhosis methods Morbidity mortality Necrosis Portal Vein ChildUI - 21181117 LA - eng PT - Journal Article DA - 20010404 IS - 0930-2794 SB - IM CY - Germany JC - VBF RefMgr field[1]: Journal RefMgr field[8]: Not in File141-145 Surg.Endosc.152]BACKGROUND: The laparoscopic approach to radiofrequency interstitial thermal ablation (RITA) of hepatocellular carcinoma (HCC) with intraoperative ultrasound guidance has been proposed with the aim of obtaining additional information for a better neoplastic staging and a complete and effective treatment of the liver lesions in patients with a difficult percutaneous approach. METHODS: In this pilot study, 29 patients with HCC in liver cirrhosis were submitted to laparoscopic RITA under sonographic guide. Most of these patients were in Child's A class of liver function. Patients with large tumors (> 5 cm), portal vein thrombosis, or severe liver disease (Child's C class) were excluded from the study. RESULTS: The laparoscopic RITA procedure was completed in 27 of 29 patients (93% feasibility rate). The laparoscopic ultrasound examination identified new malignant liver nodules in five patients (18.5%). A total of 44 lesions were treated. The mean operative time was 75.8 +/- 20.5 min (range, 45-120 min), and the mean RITA time was 18 +/- 10 min (range, 10-56 min). There was no operative mortality, and postoperative morbidity was low (four cases) without any mortality. A complete tumor necrosis was observed in 90% of the patients via spiral computed tomography (CT) 1 month after treatment. CONCLUSIONS: Laparoscopic RITA of hepatocellular carcinoma proved to be a safe and effective technique, at least in the short term. Its role in the treatment of HCC needs to be defined in larger series'zsIstituto di Chirurgia Generale e Oncologia Chirurgica, Ospedale Maggiore, IRCCS Universita di Milano, Milano, Italy195 PM:11285956VPLaparoscopic radiofrequency of hepatocellular carcinoma (HCC) in liver cirrhosisd^Montorsi,M. Santambrogio,R. Bianchi,P. Opocher,E. Tagliaferri,B. Zuin,M. Bertolini,E. Podda,M. 2001 1/2001F@Liver Liver Cirrhosis mortality Necrosis therapy UltrasonographyUI - 21167031 LA - eng PT - Journal Article DA - 20010327 IS - 0172-6390 SB - IM CY - Greece JC - GA7 RefMgr field[1]: Journal RefMgr field[8]: Not in FileR 41-45[Hepatogastroenterology4837vpBACKGROUND/AIMS: In this report, the feasibility and efficacy of laparoscopic radiofrequency interstitial thermal ablation of hepatocellular carcinoma has been evaluated in 20 patients. METHODOLOGY: The laparoscopic approach with the use of intraoperative ultrasonography allowed us to obtain additional information regarding liver nodules and a complete treatment of the liver lesions. RESULTS: The complication rate was low and there was no operative mortality. A complete necrosis has been obtained in 90% of the cases at 1 month dynamic computed tomography following the treatment. CONCLUSIONS: Laparoscopic radiofrequency thermal ablation of hepatocellular carcinoma proved to be a safe and effective technique; its use may be proposed in selected patients. Larger series are needed to accurately assess its role among the other ablative therapies of hepatocellular carcinoma'ztIstituto di Chirurgia Generale e Oncologia Chirurgica-Ospedale Maggiore IRCCS, Milan, Italy. marco.montorsi@unimi.it196 PM:11268995  etiology Europe Femalerge FluorouracilFollow-Up Studies Forecasting(#Gadolinium DTPA/du [Diagnostic Use] Gastrointestinal Neoplasms GelatinGelatin Sponge,AbsorbableHeatoHemobilia/et [Etiology] HemorrhageHemothorax/et [Etiology]Hemothorax/th [Therapy] HepatectomyHepatectomy/mt [Methods]Hepatic Artery$ Hepatitis B,Chronic/th [Therapy],(Hepatitis B,Chronic/us [Ultrasonography] Hepatitis CHumanHyperthermia,InducedInfusions,Intra-ArterialInjections,Intralesional injuriesinstrumentationlaIntraoperative Period Kidney LaparoscopyyoLaparoscopy/mt [Methods]s LaparotomyylaLength of Stay Linear ModelsLiver Liver AbscessLiver Cirrhosis Liver Cirrhosis/su [Surgery] Liver Cirrhosis/th [Therapy]($Liver Cirrhosis/us [Ultrasonography]n Liver FailureLiver Neoplasmson$!Liver Neoplasms/bs [Blood Supply]$Liver Neoplasms/di [Diagnosis]$!Liver Neoplasms/dt [Drug Therapy]$Liver Neoplasms/mo [Mortality]$Liver Neoplasms/pa [Pathology]nta$ Liver Neoplasms/ra [Radiography]]$Liver Neoplasms/sc [Secondary]nta Liver Neoplasms/su [Surgery]($Liver Neoplasms/us [Ultrasonography]Liver/pa [Pathology]Lung$Magnetic Resonance Angiography Magnetic Resonance ImagingMaler Melanomao methodsao Middle Agelas,)Monitoring, Intraoperative/st [Standards] Morbidity mortalityMyocardial Infarction Necrosiso NeedlesAg Neoplasm Recurrence, LocalNeoplasm Recurrence,Local,&Neoplasm Recurrence,Local/su [Surgery]nl$Neoplasm Staging/st [Standards]Neoplasm,Residual("Neoplasm,Residual/ra [Radiography],&Neoplasm,Residual/us [Ultrasonography] NeoplasmsNeoplasms/di [Diagnosis]Neoplasms/pa [Pathology]Neoplasms/su [Surgery]Neuroendocrine Tumors Nitrogen Octreotide pathologyPatient SelectionPleural Effusion$Pleural Effusion/et [Etiology](#Polysaccharides/du [Diagnostic Use] Portal Vein Postoperative ComplicationsPostoperative Hemorrhage,&Postoperative Hemorrhage/et [Etiology]Postoperative Period$ Preoperative Care/st [Standards]Prospective Studiesum PuncturesQuality of Life Radiation Radio Waves radiographyRadiography,AbdominalRadiology,Interventional Recurrencee SRegional Blood FlowRetrospective StudiesRiskr Safetyenc<7Saline Solution,Hypertonic/ad [Administration & Dosage] Sarcoma secondary secretion Sensitivity and SpecificitySingle-Blind MethodSupport, Non-U.S. Gov'tSupport,Non-U.S.Gov'tSupport,U.S.Gov't,P.H.S. surgerym Surgical Procedures,OperativeSurvival Analysis Survival RateSwine Syndrome Temperatureastherapeutic use therapytu Time FactorsTomography,X-Ray ComputedTreatment FailureTreatment OutcomeUltrasonographyy Ultrasonography,Doppler,Color$Ultrasonography,Interventionalnta$Ultrasonography/st [Standards] United StatesVideo-Assisted Surgery0 6  546,ZSPercutaneous treatment of small hepatic tumors by an expandable RF needle electrodel|vRossi,S. Buscarini,E. Garbagnati,F. Di Stasi,M. Quaretti,P. Rago,M. Zangrandi,A. Andreola,S. Silverman,D. Buscarini,L. 1998 4/1998 *Carcinoma,Hepatocellular/su [Surgery] *Electrocoagulation/is [Instrumentation] *Liver Neoplasms/su [Surgery] *Needles Aged Aged,80 and over Carcinoma,Hepatocellular/ra [Radiography] Carcinoma,Hepatocellular/us [Ultrasonography] complications Electrocoagulation/mt [Methods] Electrodes Female Human Liver Neoplasms/ra [Radiography] Liver Neoplasms/sc [Secondary] Liver Neoplasms/us [Ultrasonography] Male methods Middle Age Necrosis Punctures Recurrence Support,Non-U.S.Gov't Tomography,X-Ray Computed United States 1015-1022,%AJR.American Journal of Roentgenology 1704us guided Percutaneous CT evaluation after, HCC: 6/21 recurred; mets 9/11 recurred (1 local, 8 other hepatic or extrahepatic). Residual tumor in 1/5 resection specimens. Describes expandable hooks on electrode. OBJECTIVE: The aim of this study was to evaluate the usefulness of expandable RF needle electrodes in the treatment of hepatic cancer. SUBJECTS AND METHODS: Thirty-seven patients, 23 of whom had 26 hepatocellular carcinoma nodules and 14 of whom had 19 hepatic metastatic nodules, underwent treatment by RF interstitial thermal ablation with expandable needle electrodes. Forty-five tumor nodules were treated in 64 RF interstitial thermal ablation sessions with 83 needle electrode insertions. The mean diameter of the tumor nodules was 2.5 cm (range, 1.1-3.5 cm). Immediate posttreatment tumor necrosis was evaluated by dynamic CT in all cases. Two patients with hepatocellular carcinoma and three patients with metastases underwent surgical resection 20-60 days after RF treatment. The remaining 32 patients were followed up clinically. RESULTS: The mean number of RF interstitial thermal ablation sessions to complete tumor nodule treatment was 1.4. Mean number of needle electrode insertions was 1.8. No complications were observed. Posttreatment dynamic CT showed a completely nonenhancing area in the site of the treated tumor in 44 of 45 cases. The remaining patient with metastatic disease had persistent enhancing tissue. Histology showed complete necrosis in four treated tumor nodules and residual viable cancer in one. Twenty-one patients with hepatocellular carcinoma were followed up for 6-19 months (mean, 10 months). Of these patients, six showed recurrences and 15 remained apparently disease-free. Two patients died, one from advanced cancer and one from other causes. Eleven patients with hepatic metastases were followed up for 7-20 months (mean, 12 months). Of these patients, nine showed recurrent disease and only two remained apparently disease-free. Two patients died from disseminated disease. CONCLUSION: RF interstitial thermal ablation of hepatic tumor by expandable needle electrodes is a safe and effective technique. Local ablation of tumors not exceeding 3.5 cm in diameter is achieved in a short time without complicationsVPDB - MEDLINE UI - 98191083 IN - Department of Gastroenterology, Hospital of Piacenza, Italy JC - 3ae, 3AE, 3AE, 7708173 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 19980416 Revised: 20001218. Entry Week: 19980416 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0361-803X53}Percutaneous radio-frequency thermal ablation of nonresectable hepatocellular carcinoma after occlusion of tumor blood supplyRossi,S. Garbagnati,F. Lencioni,R. Allgaier,H.P. Marchiano,A. Fornari,F. Quaretti,P. Tolla,G.D. Ambrosi,C. Mazzaferro,V. Blum,H.E. Bartolozzi,C. 200010/2000enh*Carcinoma,Hepatocellular/su [Surgery] *Electrocoagulation/mt [Methods] *Liver Neoplasms/su [Surgery] *Liver/bs [Blood Supply] 0 (Contrast Media) 0 (Gelatin Sponge,Absorbable) 80529-93-7 (Gadolinium DTPA) Aged analysis Balloon Dilatation blood blood supply Carcinoma,Hepatocellular/bs [Blood Supply] complications Contrast Media Female Follow-Up Studies Gadolinium DTPA/du [Diagnostic Use] Gelatin Gelatin Sponge,Absorbable Hepatic Artery Human Liver Neoplasms/bs [Blood Supply] Magnetic Resonance Angiography Male methods Middle Age Necrosis Recurrence Risk Tomography,X-Ray Computed Treatment Outcome United States119-126 Radiology 2171PURPOSE: To evaluate the usefulness of percutaneous radio-frequency (RF) thermal ablation of nonresectable hepatocellular carcinoma (HCC) after occlusion of the tumor arterial supply. MATERIALS AND METHODS: Sixty-two patients with cirrhosis and biopsy-proved HCC underwent RF ablation after interruption of the tumor arterial supply by means of occlusion of either the hepatic artery with a balloon catheter (40 patients) or the feeding arteries with gelatin sponge particles (22 patients). RESULTS: After a single RF procedure in 56 patients and after two procedures in six patients, spiral computed tomography (CT) demonstrated a nonenhancing area corresponding in shape to the previously identified HCC, which was suggestive of complete necrosis. No major complications occurred. Two patients subsequently underwent surgical resection; the remaining 60 patients were followed up with spiral CT. During a mean follow-up of 12.1 months, 11 HCC nodules showed areas of local progression; 49 were identified as nonenhancing areas with a 40%-75% reduction in maximum diameter. The 1-year estimate of failure risk was 19% for local recurrence and 45% for overall intrahepatic recurrence. The estimated 1-year survival was 87%. Histopathologic analysis of one autopsy and two surgical specimens revealed more than 90% necrosis in one specimen and 100% necrosis in two. CONCLUSION: HCC nodules 3.5-8.5 cm in diameter can be ablated in one or two RF sessions after occlusion of the tumor arterial supplym|uDB - MEDLINE UI - 20467608 IN - Depts of Gastroenterology, Emergency Medicine, and Radiology, Public Hospital of Piacenza, Italy JC - qsh, QSH, QSH, 0401260 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 20001017 Revised: 20001218. Entry Week: 20001017 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0033-8419d 577rlPercutaneous radiofrequency interstitial thermal albation in the treatment of small hepatocellular carcinoma`YRossi S Di Stasi M Buscarini E Cavanna L Quaretti P Squassante E Garbagnati F Buscarini L9 1995 1995<5RefMgr field[1]: Journal RefMgr field[8]: Not in Filel 73-81o2+The Cancer Journal from Scientific Americana1hhumans, 24 subjects with 25 HCCs, 13 had recurrences at 6-64 months, mention in discussion of possibility of using bipolar arrays. Residual focus of tumor in one resection specimen.b$RRadiofrequency ablation treatment of refractory carcinoid hepatic metastasesWessels,F.J. Schell,S.R. 2001 1/2001Adult Carcinoid Tumor Chemoembolization,Therapeutic Female Hepatic Artery Human Liver Neoplasms Male methods Middle Age Octreotide Radio Waves radiography secondary surgery Syndrome therapeutic use therapy Tomography,X-Ray Computed United StatesUI - 20570385 LA - eng RN - 83150-76Solbiati, Luigi Livraghi, Tito Goldberg, S. Nahum Ierace, Tiziana Meloni, Franca Dellanoce, Marina Cova, Luca Halpern, Elkan F. Gazelle, G. Scotti|uPercutaneous Radio-frequency Ablation of Hepatic Metastases from Colorectal Cancer: Long-term Results in 117 Patientsr 2001 Radiology  Radiologyi159-166l 221o1mB