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01-04-2020 | Ultrasound | Review Article

Laparoscopic thermoablation for hepatocellular carcinoma in patients with liver cirrhosis: an effective procedure for tricky tumors

Authors: Roberto Santambrogio, Matteo Barabino, Valentina D’Alessandro, Elisa Galfrascoli, Marco Antonio Zappa, Gaetano Piccolo, Massimo Zuin, Enrico Opocher

Published in: Medical Oncology | Issue 4/2020

Abstract

The optimal treatment for hepatocellular carcinoma (HCC) is surgical resection. However, only a small percentage of patients are amenable to this option. Percutaneous radiofrequency interstitial thermal ablation (TA) proved to be effective in the treatment of unresectable HCC. Recent advances in laparoscopic ultrasound have improved the accuracy in detecting small intrahepatic HCC nodules missed by pre-operative imaging techniques. Our objective was to evaluate an operative combination of laparoscopic ultrasound with laparoscopic thermoablation (LTA) in the treatment of HCC not amenable to liver resection. The aim of our review was to evaluate the advantages and limits of the laparoscopic approach according the criteria of the evidence-based medicine. LTA of HCC proved to be a safe and effective technique both in the short- and long-term follow-up period. This technique may be indicated in selected cases when the percutaneous approach to the lesion is very difficult or contraindicated.

Lencioni R, Cioni D, Bartolozzi C. Percutaneous radiofrequency thermal ablation of liver malignancies: techniques, indications, imaging findings, and clinical results. Abdom Imaging. 2001;26:345–60.PubMed

Livraghi T, Meloni F, Di Stasi M, Rolle E, Solbiati L, Tinelli C, Rossi S. Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: is resection still the treatment of choice? Hepatology. 2008;47:82–9.PubMed

Santambrogio R, Bianchi P, Pasta A, Palmisano A, Montorsi M. Ultrasound-guided interventional procedures of the liver during laparoscopy technical considerations. Surg Endosc. 2002;16:349–54.PubMed

Ido K, Isoda N, Kawamoto C, Hozumu M, Suzuki T, Nagamine N, Nakazawa Y, Ono K, Hirota N, Hyodoh H, Kimura K. Laparoscopic microwave coagulation therapy for solitary hepatocellular carcinoma performed under laparoscopic ultrasonography. Gastrointest Endosc. 1997;45:415–20.PubMed

Ito T, Niiyama G, Kawanaka M, et al. Laparoscopic microwave coagulation for the treatment of hepatocellular carcinoma. Dig Endosc. 1999;11:137–43.

Goletti O, Lencioni R, Armillotta N, Puglisi A, Lippolis PV, Lorenzetti L, Cioni D, Musco B, Bartolozzi C, Cavina E. Laparoscopic radiofrequency thermal ablation of hepatocarcinoma: preliminary experience. Surg Laparosc Endosc Percutan Tech. 2000;10:284–90.PubMed

Podnos YD, Henry G, Ortiz JA, Ji P, Cooke J, Cao S, Imagawa DK. Laparoscopic ultrasound with radiofrequency ablation in cirrhotic patients with hepatocellular carcinoma: technique and technical considerations. Am Surg. 2001;67:1181–4.PubMed

Hsieh CB, Chang HM, Chen TW, et al. Comparison of transcatheter arterial chemoembolization, laparoscopic radiofrequency, and conservative treatment for decompensated cirrhotic patients with hepatocellular carcinoma. World J Gastroenterol. 2004;10:505–8.PubMedPubMedCentral

Ballem N, Berber E, Pitt T, Siperstein A. Laparoscopic radiofrequency ablation of unresectable hepatocellular carcinoma: long-term follow-up. HPB. 2008;10:315–20.PubMedPubMedCentral

10.

Casaccia M, Adorno E, Nardi I, et al. Laparoscopic US-guided radiofrequency ablation of unresectable hepatocellular carcinoma in liver cirrhosis: feasibility and clinical outcome. J Laparoendosc Adv Surg Tech. 2008;18:797–801.

11.

Hirooka M, Kisaka Y, Uehara T, et al. Efficacy of laparoscopic radiofrequency ablation for hepatocellular carcinoma compared to percutaneous radiofrequency ablation with artificial ascites. Dig Endosc. 2009;21:82–6.PubMed

12.

Panaro F, Piardi T, Audet M, et al. Laparoscopic ultrasound-guided radiofrequency ablation as a bridge to liver transplantation for hepatocellular carcinoma: preliminary results. Transplant Proc. 2010;42(4):1179–81.PubMed

13.

Tesche LJ, Newton KN, Unger J, Semelka RC, Gerber DA. Efficacy and tolerability of laparoscopic-assisted radiofrequency ablation of hepatocellular carcinoma in patients above 60 years of age. Surg Laparosc Endosc Percutan Tech. 2010;20:404–9.PubMed

14.

Simo KA, Sereika SE, Newton KN, Gerber DA. Laparoscopic-assisted microwave ablation for hepatocellular carcinoma: safety and efficacy in comparison with radiofrequency ablation. J Surg Oncol. 2011;104:822–9.PubMed

15.

Yoon YS, Han HS, Cho JY, Yoon CJ, Kim JH. Laparoscopic approach for treatment of multiple hepatocellular Carcinomas. Surg Endosc. 2012;26(11):3133–40.PubMed

16.

Seleem MI, Gerges SS, Elkhouly A, El-wakeel B, Hassany M. Laparoscopic radiofrequency thermal ablation of hepatocellular carcinoma in liver cirrhosis patients. Gastroenterol Res. 2012;5:232–5.

17.

Herbold T, Wahba R, Bangard C, et al. The laparoscopic approach for radiofrequency ablation of hepatocellular carcinoma-indication, technique and results. Langenbecks Arch Surg. 2013;398:47–53.PubMed

18.

Swan RZ, Sindram D, Martinie JB, Iannitti DA. Operative microwave ablation for hepatocellular carcinoma: complications, recurrence, and long-term outcomes. J Gastrointest Surg. 2013;17:719–29.PubMed

19.

Iida H, Aihara T, Ikuta S, Yamanaka N. A comparative study of therapeutic effect between laparoscopic microwave coagulation and laparoscopic radiofrequency ablation. Hepatogastroenterology. 2013;60:22–5.

20.

Jiang K, Zhang W, Su M, et al. Laparoscopic radiofrequency ablation of solitary small hepatocellular carcinoma in the caudate lobe. EJSO. 2013;39:1236–42.PubMed

21.

Jiang K, Su M, Zhao X, et al. ‘‘One-off’’ complete radiofrequency ablation of hepatocellular carcinoma adjacent to the gallbladder by a novel laparoscopic technique without gallbladder isolation. Cell Biochem Biophys. 2014;69:605–17.PubMed

22.

De la Serna S, Vilana R, SanchezCabus S, Calatayud D, Ferre J, Molina V, Fondevila C, Bruix J, Fuster J, Garcia Valdecasas JC. Results of laparoscopic radiofrequency ablation for HCC Could the location of the tumour influence a complete response to treatment? A single European Centre Experience. HPB. 2015;17:387–93.PubMed

23.

Murakami K, Naka S, Shiomi H, et al. Initial experiences with MR Image-guided laparoscopic microwave coagulation therapy for hepatic tumors. Surg Today. 2015;45:1173–8.PubMed

24.

Tang Z, Zhu Y, Tang K, et al. Laparoscopic combined with percutaneous ablation for hepatocellular carcinoma under liver capsule: a single Chinese center experience of thirty patients. J Cancer Res Ther. 2016;12:143–7.

25.

Baker EH, Thompson K, McKillop IH, et al. Operative microwave ablation for hepatocellular carcinoma: a single center retrospective review of 219 patients. J Gastrointest Oncol. 2017;8:337–46.PubMedPubMedCentral

26.

Santambrogio R, Barabino M, Bruno S, Costa M, Pisani Ceretti A, Angiolini MR, Zuin M, Meloni F, Opocher E. Long-term outcome of laparoscopic ablation therapies for unresectable hepatocellular carcinoma: a single European center experience of 426 patients. Surg Endosc. 2016;30:2103–13.PubMed

27.

Gruttadauria S, Pagano D, Tropea A, Cintorino D, Castellana L, Bonsignore P, Ricotta C, Vizzini G, Luca A. Laparoscopic approach for thermoablation microwave in the treatment of hepatocellular carcinoma: a single center experience. J Laparosc Adv Surg Tech. 2016;26(10):808–11.

28.

Na BG, Kim JM, Oh DK, et al. Clinical outcomes of laparoscopic radiofrequency ablation of single primary or recurrent hepatocellular carcinoma (≤3 cm). Ann Surg Treat Res. 2017;92:355–60.PubMedPubMedCentral

29.

Ding H, Su M, Zhu C, Wang L, Zheng Q, Wan Y. CT-guided versus laparoscopic radiofrequency ablation in recurrent small hepatocellular carcinoma against the diaphragmatic dome. Sci Rep. 2017;7:44583.PubMedPubMedCentral

30.

Eun HS, Lee BS, Kwon IS, et al. Advantages of laparoscopic radiofrequency ablation over percutaneous radiofrequency ablation in hepatocellular carcinoma. Dig Dis Sci. 2017;62:2586–600.PubMed

31.

Wang T, Zhang XY, Lu X, Zhai B. Laparoscopic microwave ablation of hepatocellular carcinoma at liver surface: technique effectiveness and long-term outcomes. Technol Cancer Res Treat. 2019;18:1–9.

32.

Cillo U, Bertacco A, Fasolo E, et al. Videolaparoscopic microwave ablation in patients with HCC at a European high-volume center: results of 815 procedures. J Surg Oncol. 2019;120:956–65.PubMed

33.

Lo CM, Lai ECS, Liu CL, Fan ST, Wong J. Laparoscopy and laparoscopic ultrasonography avoid exploratory laparotomy in patients with hepatocellular carcinoma. Ann Surg. 1998;227:527–32.PubMedPubMedCentral

34.

Kokudo N, Bandai Y, Imanishi H, et al. Management of new hepatic nodules detected by intraoperative ultrasonography during hepatic resection for hepatocellular carcinoma. Surgery. 1996;119:634–40.PubMed

35.

Takigawa Y, Sugawara Y, Yamamoto J, Shimada K, Yamasaki S, Kosuge T, Makuuchi M. New lesions detected by introperative ultrasound during liver resection for hepatocellular carcinoma. Ultrasound Med Biol. 2001;27:151–6.PubMed

36.

Torzilli G, Olivari N, Moroni E, et al. Contrast-enhanced intraoperative ultrasonography in surgery for hepatocellular carcinoma in cirrhosis. Liver Transpl. 2004;10:S34–S3838.PubMed

37.

Lai ECH, Tang CN, Ha JPY, Tsui DKK, Li MKW. The evolving influence of laparoscopy and laparoscopic ultrasonography on patients with hepatocellular carcinoma. Am J Surg. 2008;196:736–40.PubMed

38.

Ido K, Nakazawa Y, Isoda N, et al. The role of laparoscopic US and laparoscopic US-guided aspiration biopsy in the diagnosis of multicentric hepatocellular carcinoma. Gastrointest Endosc. 1999;50:523–6.PubMed

39.

Klegar EK, Marcus SG, Newman E, Hiotis SP. Diagnostic laparoscopy in the evaluation of the viral hepatitis patient with potentially resectable hepatocellular carcinoma. HPB. 2005;7:204–7.PubMedPubMedCentral

40.

Reddy MS, Smith L, Jaques BC, et al. Do laparoscopy and intraoperative ultrasound have a role in the assessment of patients with end-stage liver disease and hepatocellular carcinoma for liver transplantation? Transpl Proc. 2007;39:1474–6.

41.

Brunello F, Cantamessa A, Gaia S, Carucci P, Rolle E, Castiglione A, Ciccone G, Rizzetto M. Radiofrequency ablation: technical and clinical long-term outcomes for single hepatocellular carcinoma up to 30 mm. Eur J Gastroenterol Hepatol. 2013;25:842–9.PubMed

42.

Lee DH, Lee JM, Lee JY, Kim SH, Yoon JH, Kim YJ, Han JK, Choi BI. Radiofrequency ablation of hepatocellular carcinoma as first-line treatment: long-term results and prognostic factors in 162 patients with cirrhosis. Radiology. 2014;270:900–9.PubMed

43.

Chinnaratha MA, Chuang MA, Fraser RJ, Woodman RJ, Wigg AJ. Percutaneous thermal ablation for primary hepatocellular carcinoma: a systematic review and meta-analysis. J Gastroenterol Hepatol. 2016;45:1230–5.

44.

Poulou LS, Botsa E, Thanou I, Ziakas PD, Thanos L. Percutaneous microwave ablation vs radiofrequency ablation in the treatment of hepatocellular carcinoma. World J Hepatol. 2015;7:1054–63.PubMedPubMedCentral

45.

Kim JW, Shin SS, Heo SH, Hong JH, Lim HS, Seon HJ, Hur YH, Park CH, Jeong YY, Kang HK. Ultrasound-guided percutaneous radiofrequency ablation of liver tumors: how we do it safely and completely. Korean J Radiol. 2015;16:1226–399.PubMedPubMedCentral

46.

Montorsi M, Santambrogio R, Bianchi P, Dapri G, Spinelli A, Podda M. Perspectives and drawbacks of minimally invasive surgery for hepatocellular carcinoma. Hepatogastroenterology. 2002;49:56–61.PubMed

47.

Mulier S, Mulier P, Ni Y, et al. Complications of radiofrequency coagulation of liver tumors. Br J Surg. 2002;89:1206–22.PubMed

48.

Gillams AR. Radiofrequency ablation in the management of liver tumors. EJSO. 2003;29:9–16.PubMed

49.

Montorsi M, Santambrogio R, Bianchi P, et al. Laparoscopy with laparoscopic ultrasound (L-LUS) for the pre-treatment staging of hepatocellular carcinoma: a prospective study. Gastrointestinal Surg. 2001;5:312–5.

Title: Laparoscopic thermoablation for hepatocellular carcinoma in patients with liver cirrhosis: an effective procedure for tricky tumors
Authors: Roberto Santambrogio
Matteo Barabino
Valentina D’Alessandro
Elisa Galfrascoli
Marco Antonio Zappa
Gaetano Piccolo
Massimo Zuin
Enrico Opocher
Publication date: 01-04-2020
Publisher: Springer US
Keywords: Ultrasound
Liver Cirrhosis
Hepatocellular Carcinoma
Hepatocellular Carcinoma
Ultrasound
Published in: Medical Oncology / Issue 4/2020
Print ISSN: 1357-0560
Electronic ISSN: 1559-131X
DOI: https://doi.org/10.1007/s12032-020-1342-5

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