Seror Olivier, Haddar Djamel, N'Kontchou Gisèle, Ajavon Yves, Trinchet Jean-Claude, Beaugrand Michel, Sellier Nicolas
Department of Radiology, Centre Hospitalier Universitaire Jean Verdier and UPRES EA 3409, UFR SMBH, Paris XIII, France.
J Vasc Interv Radiol. 2005 Jul;16(7):981-90. doi: 10.1097/01.RVI.0000159859.71448.8A.
To evaluate the effectiveness of radiofrequency (RF) ablation for liver tumors located in the caudate lobe.
Ten patients (46-79 years of age; median, 70 y), eight with hepatocellular carcinoma (HCC) and cirrhosis and two with colorectal metastases in the caudate lobe, were treated with 5.8% NaCl tissue-perfused monopolar (n=7) or bipolar (n=3) RF ablation. The median tumor diameter was 41 mm (range, 25-70 mm). Procedures were performed under ultrasound and computed tomography (CT) guidance in eight and two patients, respectively. One month later, the treatment response was assessed by CT.
Transhepatic right intercostal and transomental anterior epigastric routes were used for tumor puncture in eight and two patients, respectively. The entire RF ablation treatment required one or two procedures (median, 1.5), including two to 15 electrode repositionings (median, 6). After RF ablation procedure, one patient experienced jaundice that resolved spontaneously. In one patient, CT follow-up showed asymptomatic segmental biliary duct dilations. Median total hospital stay was 3 days (range, 2-9 d). Complete ablation was achieved in nine of 10 tumors. In one patient, ethanol ablation was necessary to complete RF ablation treatment. After a median follow up of 9.5 months (range, 5-25 mo), three patients remained tumor-free and seven had tumor relapse: two local, four distant, and one mixed. Repeat RF ablation was successfully performed in four cases.
RF ablation of liver tumors located in the caudate lobe is effective despite the deep location of tumors and the vicinity of major vessels.
评估射频（RF）消融治疗尾状叶肝肿瘤的有效性。
10例患者（年龄46 - 79岁；中位年龄70岁），其中8例为肝细胞癌（HCC）合并肝硬化，2例为尾状叶结直肠癌转移，接受了5.8% NaCl组织灌注单极（n = 7）或双极（n = 3）射频消融治疗。肿瘤中位直径为41 mm（范围25 - 70 mm）。分别在超声和计算机断层扫描（CT）引导下对8例和2例患者进行了手术。1个月后，通过CT评估治疗反应。
分别有8例和2例患者经肝右肋间途径和经网膜上腹部前途径进行肿瘤穿刺。整个射频消融治疗需要进行1或2次手术（中位次数1.5），包括2至15次电极重新定位（中位次数6）。射频消融术后，1例患者出现黄疸，后自行消退。1例患者CT随访显示无症状性节段性胆管扩张。中位总住院时间为3天（范围2 - 9天）。10个肿瘤中有9个实现了完全消融。1例患者需要乙醇消融来完成射频消融治疗。中位随访9.5个月（范围5 - 25个月）后，3例患者无肿瘤复发，7例出现肿瘤复发：2例局部复发，4例远处复发，1例混合复发。4例患者成功进行了重复射频消融。
尽管尾状叶肝肿瘤位置深且靠近主要血管，但射频消融治疗仍有效。
