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Stereotactic Radiofrequency Ablation of Unresectable Intrahepatic Cholangiocarcinomas: A Retrospective Study

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Abstract

Purpose

To evaluate treatment effects, complications, and outcome of percutaneous stereotactic radiofrequency ablation (SRFA) of intrahepatic cholangiocarcinoma (ICC).

Patients and Methods

Eleven consecutive patients (nine men and two women) with a total of 36 inoperable ICCs (18 initial lesions, 16 lesions newly detected during follow-up, and two local recurrences) underwent SRFA between December 2004 and June 2010. Two different radiofrequency ablation (RFA) devices with internally cooled electrodes were used. Tumor diameters ranged from 0.5 to 10 cm (median 3.0 cm). A total of 23 SRFA sessions were performed. The efficacy of SRFA was evaluated by contrast-enhanced computed tomography or magnetic resonance imaging 1 month after treatment and then every 3 months.

Results

Primary technical effectiveness rate was 92%. Further follow-up every 3 months revealed three local recurrences (8%), two of which were successfully retreated, resulting in a secondary technical effectiveness rate of 98%. After a total of 23 RFA sessions, three major complications occurred (13%) that could be managed interventionally. Mean follow-up time was 35 months (range 12–81 months). One- and 3-year overall survival rates were 91 and 71%, respectively. The median overall survival was 60 months (according to the life table method). Eight (73%) of 11 patients were still alive at the end of follow-up.

Conclusion

SRFA is effective in the treatment of unresectable ICC even if the tumor is large and located close to major vessels. SRFA shows a survival benefit compared to other palliative treatment options and may also be considered as the first-line local treatment of ICCs in selected patients.

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Acknowledgment

The authors would like to thank Michael Vogele, MD for the technical support and the radiation technicians Thomas Lang, Martin Knoflach, Christoph Hinterleithner, Martin Fasser, Julia Mahlknecht and Florian Schanda for their assistance.

Conflict of interest

R.B. is a coinventor of the Atlas aiming device and coshareholder in its financial returns

Author information

Authors and Affiliations

  1. Clinic of Radiology, Department of Microinvasive Therapy (SIP), Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Marion Haidu, Peter Schullian, Gerlig Widmann & Reto Bale

  2. Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria

    Georg Dobrozemsky

  3. Department of Surgery, Medical University Innsbruck, Innsbruck, Austria

    Alexander Klaus, Helmut Weiss & Raimund Margreiter

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  1. Marion Haidu
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  2. Georg Dobrozemsky
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  3. Peter Schullian
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  4. Gerlig Widmann
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  8. Reto Bale
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Correspondence to Reto Bale.

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Haidu, M., Dobrozemsky, G., Schullian, P. et al. Stereotactic Radiofrequency Ablation of Unresectable Intrahepatic Cholangiocarcinomas: A Retrospective Study. Cardiovasc Intervent Radiol 35, 1074–1082 (2012). https://doi.org/10.1007/s00270-011-0288-6

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  • DOI: https://doi.org/10.1007/s00270-011-0288-6

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