Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of the efficacy and postoperative outcomes of hydrodissection-assisted microwave ablation for subcapsular hepatocellular carcinoma and colorectal liver metastases

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To explore the effect of hydrodissection assisted percutaneous microwave ablation (MWA) on the primary technique efficacy (PTE) and local tumor progression (LTP) of subcapsular hepatocellular carcinoma (HCC) and colorectal liver metastases (CRLM).

Methods

A retrospective review of 135 patients with 181 hepatic subcapsular HCC and CRLM that underwent MWA with (hydrodissection group) and without the use of hydrodissection (control group). The PTE, cumulative LTP rate, and postoperative complications were compared between the two groups.

Results

Amongst the 135 patients with 181 tumors, 60 patients with 72 tumors were in the hydrodissection group and 75 patients with 109 tumors were in the control group. The PTEs were 97.2% and 85.3% in hydrodissection and control groups, respectively (P = 0.019). Multivariate analysis showed that hydrodissection significantly improved the PTE of MWA [odds ratio (OR) 0.147; 95% confidence interval (CI) 0.031–0.703; P = 0.016). Among the tumors which achieved complete response at the first (1 month) follow-up, the overall LTP rates were 8.6% (6/70) and 11.8% (11/93) in the hydrodissection and control groups, respectively. The 1- and 2-year cumulative LTP rates were 3.0% and 5.0% for the hydrodissection group and 6.8% and 13.5% in the control group, respectively (P = 0.391). No significant differences were observed in major postoperative complications between the two groups.

Conclusion

Hydrodissection-assisted MWA had a significantly higher PTE than MWA alone in hepatic subcapsular HCC and CRLM. Hydrodissection did not significantly impact the cumulative LTP rate or the incidence of postoperative complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

Data availability

The approval of data and material was obtained from participants.

Consent for publication

Not applicable.

Code availability

Not applicable.

References

  1. T. Hori, K. Nagata, S. Hasuike, et al. (2003) Risk factors for the local recurrence of hepatocellular carcinoma after a single session of percutaneous radiofrequency ablation. Journal of gastroenterology 10: 977–981. https://doi.org/10.1007/s00535-003-1181-0

    Article  Google Scholar 

  2. S. Mulier, Y. Ni, J. Jamart, T. Ruers, G. Marchal, L. Michel (2005) Local recurrence after hepatic radiofrequency coagulation: multivariate meta-analysis and review of contributing factors. Annals of Surgery 2: 158–171. https://doi.org/10.1097/01.sla.0000171032.99149.fe

    Article  Google Scholar 

  3. P. Filippousis, E. Sotiropoulou, A. Manataki, O. Konstantinopoulos, L. Thanos (2011) Radiofrequency ablation of subcapsular hepatocellular carcinoma: single center experience. European journal of radiology 2: 299–304. https://doi.org/10.1016/j.ejrad.2009.07.003

    Article  Google Scholar 

  4. L.N. Liu, H.X. Xu, M.D. Lu, X.Y. Xie (2010) Percutaneous ultrasound-guided thermal ablation for liver tumor with artificial pleural effusion or ascites. Chinese journal of cancer 9: 830–835.

    Article  Google Scholar 

  5. M. Zhang, P. Liang, Z.G. Cheng, X.L. Yu, Z.Y. Han, J. Yu (2014) Efficacy and safety of artificial ascites in assisting percutaneous microwave ablation of hepatic tumours adjacent to the gastrointestinal tract. International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group 2: 134–141. https://doi.org/10.3109/02656736.2014.891765

    Article  Google Scholar 

  6. C.C. Wang, J.H. Kao (2015) Artificial ascites is feasible and effective for difficult-to-ablate hepatocellular carcinoma. Hepatology international 4: 514–519. https://doi.org/10.1007/s12072-015-9639-8

    Article  Google Scholar 

  7. N.H. Asvadi, A. Anvari, R.N. Uppot, A. Thabet, A.X. Zhu, R.S. Arellano (2016) CT-Guided Percutaneous Microwave Ablation of Tumors in the Hepatic Dome: Assessment of Efficacy and Safety. Journal of vascular and interventional radiology : JVIR 4: 496–502; quiz 503. https://doi.org/10.1016/j.jvir.2016.01.010

  8. D.K. Filippiadis, S. Spiliopoulos, C. Konstantos, et al. (2018) Computed tomography-guided percutaneous microwave ablation of hepatocellular carcinoma in challenging locations: safety and efficacy of high-power microwave platforms. International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group 6: 863–869. https://doi.org/10.1080/02656736.2017.1370728

    Article  Google Scholar 

  9. Y.C. Hsieh, J.L. Limquiaco, C.C. Lin, W.T. Chen, S.M. Lin (2019) Radiofrequency ablation following artificial ascites and pleural effusion creation may improve outcomes for hepatocellular carcinoma in high-risk locations. Abdominal radiology (New York) 3: 1141–1151. https://doi.org/10.1007/s00261-018-1831-6

    Article  Google Scholar 

  10. S.Y. Nam, H. Rhim, T.W. Kang, et al. (2010) Percutaneous radiofrequency ablation for hepatic tumors abutting the diaphragm: clinical assessment of the heat-sink effect of artificial ascites. AJR. American journal of roentgenology 2: W227–231. https://doi.org/10.2214/ajr.09.2979

    Article  Google Scholar 

  11. T.W. Kang, H.K. Lim, M.W. Lee, Y.S. Kim, D. Choi, H. Rhim (2013) First-line radiofrequency ablation with or without artificial ascites for hepatocellular carcinomas in a subcapsular location: local control rate and risk of peritoneal seeding at long-term follow-up. Clinical radiology 12: e641–651. https://doi.org/10.1016/j.crad.2013.07.008

    Article  Google Scholar 

  12. T.W. Kang, H.K. Lim, M.W. Lee, et al. (2016) Long-term Therapeutic Outcomes of Radiofrequency Ablation for Subcapsular versus Nonsubcapsular Hepatocellular Carcinoma: A Propensity Score Matched Study. Radiology 1: 300–312. https://doi.org/10.1148/radiol.2016151243

    Article  Google Scholar 

  13. M. Ahmed, L. Solbiati, C.L. Brace, et al. (2014) Image-guided tumor ablation: standardization of terminology and reporting criteria–a 10-year update. Radiology 1: 241–260. https://doi.org/10.1148/radiol.14132958

    Article  Google Scholar 

  14. D. Sacks, T.E. McClenny, J.F. Cardella, C.A. Lewis (2003) Society of Interventional Radiology clinical practice guidelines. Journal of vascular and interventional radiology : JVIR 9 Pt 2: S199–202. https://doi.org/10.1097/01.rvi.0000094584.83406.3e

    Article  Google Scholar 

  15. K. Ohmoto, M. Tsuduki, N. Shibata, M. Takesue, T. Kunieda, S. Yamamoto (1999) Percutaneous microwave coagulation therapy for hepatocellular carcinoma located on the surface of the liver. AJR. American journal of roentgenology 5: 1231–1233. https://doi.org/10.2214/ajr.173.5.10541094

    Article  Google Scholar 

  16. D. Kitchin, M. Lubner, T. Ziemlewicz, et al. (2014) Microwave ablation of malignant hepatic tumours: intraperitoneal fluid instillation prevents collateral damage and allows more aggressive case selection. International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group 5: 299–305. https://doi.org/10.3109/02656736.2014.936050

    Article  Google Scholar 

  17. N.N. Zhang, W. Lu, X.J. Cheng, J.Y. Liu, Y.H. Zhou, F. Li (2015) High-powered microwave ablation of larger hepatocellular carcinoma: evaluation of recurrence rate and factors related to recurrence. Clinical radiology 11: 1237–1243. https://doi.org/10.1016/j.crad.2015.06.092

    Article  Google Scholar 

  18. X.G. Zhang, Z.L. Zhang, S.Y. Hu, Y.L. Wang (2014) Ultrasound-guided ablative therapy for hepatic malignancies : a comparison of the therapeutic effects of microwave and radiofrequency ablation. Acta chirurgica Belgica 1: 40–45.

    Article  Google Scholar 

  19. S. Qin, G.J. Liu, M. Huang, et al. (2019) The local efficacy and influencing factors of ultrasound-guided percutaneous microwave ablation in colorectal liver metastases: a review of a 4-year experience at a single center. International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group 1: 36–43. https://doi.org/10.1080/02656736.2018.1528511

    Article  Google Scholar 

  20. W.J. Heerink, A.M. Solouki, R. Vliegenthart, et al. (2018) The relationship between applied energy and ablation zone volume in patients with hepatocellular carcinoma and colorectal liver metastasis. European radiology 8: 3228–3236. https://doi.org/10.1007/s00330-017-5266-1

    Article  Google Scholar 

  21. M. Calandri, S. Yamashita, C. Gazzera, et al. (2018) Ablation of colorectal liver metastasis: Interaction of ablation margins and RAS mutation profiling on local tumour progression-free survival. European radiology 7: 2727–2734. https://doi.org/10.1007/s00330-017-5273-2

    Article  Google Scholar 

  22. B.C. Odisio, S. Yamashita, S.Y. Huang, et al. (2017) Local tumour progression after percutaneous ablation of colorectal liver metastases according to RAS mutation status. The British journal of surgery 6: 760–768. https://doi.org/10.1002/bjs.10490

    Article  CAS  Google Scholar 

  23. C.-H. Liu, R.S. Arellano, R.N. Uppot, A.E. Samir, D.A. Gervais, P.R. Mueller (2010) Radiofrequency ablation of hepatic tumours: effect of post-ablation margin on local tumour progression. European radiology 4: 877–885. https://doi.org/10.1007/s00330-009-1610-4

    Article  Google Scholar 

  24. D. Choi, H.K. Lim, H. Rhim, et al. (2007) Percutaneous radiofrequency ablation for early-stage hepatocellular carcinoma as a first-line treatment: long-term results and prognostic factors in a large single-institution series. European radiology 3: 684–692. https://doi.org/10.1007/s00330-006-0461-5

    Article  Google Scholar 

  25. D.H. Lee, J.M. Lee, J.Y. Lee, et al. (2014) Radiofrequency ablation of hepatocellular carcinoma as first-line treatment: long-term results and prognostic factors in 162 patients with cirrhosis. Radiology 3: 900–909. https://doi.org/10.1148/radiol.13130940

    Article  Google Scholar 

  26. I. Song, H. Rhim, H.K. Lim, Y.S. Kim, D. Choi (2009) Percutaneous radiofrequency ablation of hepatocellular carcinoma abutting the diaphragm and gastrointestinal tracts with the use of artificial ascites: safety and technical efficacy in 143 patients. European radiology 11: 2630–2640. https://doi.org/10.1007/s00330-009-1463-x

    Article  Google Scholar 

  27. T.W. Kang, M.W. Lee, M.J. Hye, et al. (2014) Percutaneous radiofrequency ablation of hepatic tumours: factors affecting technical failure of artificial ascites formation using an angiosheath. Clinical radiology 12: 1249–1258. https://doi.org/10.1016/j.crad.2014.07.012

    Article  Google Scholar 

  28. J. Garnon, R.L. Cazzato, J. Caudrelier, et al. (2019) Adjunctive Thermoprotection During Percutaneous Thermal Ablation Procedures: Review of Current Techniques. Cardiovascular and interventional radiology 3: 344–357. https://doi.org/10.1007/s00270-018-2089-7

    Article  Google Scholar 

Download references

Acknowledgments

This study is partially supported by the National Natural Science Foundation of China (No. 81771944, 82072037); Liaoning Innovative Talents Supporting Program; Shenyang Innovative Talents Supporting Program (No. RC170048).

Funding

No additional funding was required for this study.

Author information

Authors and Affiliations

  1. Department of Radiology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang, 110001, China

    Chong Liu, Jintong He, Tian Li, Duo Hong, Hongying Su & Haibo Shao

Authors
  1. Chong Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jintong He
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tian Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Duo Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hongying Su
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Haibo Shao
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by CL, JH, TL, DH, and HS. The first draft of the manuscript was written by CL and HS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Haibo Shao.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the Ethical Standards of the Institutional and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liu, C., He, J., Li, T. et al. Evaluation of the efficacy and postoperative outcomes of hydrodissection-assisted microwave ablation for subcapsular hepatocellular carcinoma and colorectal liver metastases. Abdom Radiol 46, 2161–2172 (2021). https://doi.org/10.1007/s00261-020-02830-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-020-02830-x

Keywords

Search

Navigation