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Tesi etd-07182018-102240


Thesis type
Tesi di specializzazione (5 anni)
Author
ROSSI, PIERCARLO
URN
etd-07182018-102240
Title
Efficacy of microwave ablation for HCC: correlation with pathological examination after total hepatectomy in patients submitted to liver transplantation
Struttura
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
RADIODIAGNOSTICA
Commissione
relatore Prof. Caramella, Davide
correlatore Prof.ssa Crocetti, Laura
Parole chiave
  • orthotopic liver transplant
  • interventional radiology
  • hepatocellular carcinoma
  • microwave ablation
Data inizio appello
08/08/2018;
Consultabilità
parziale
Data di rilascio
08/08/2021
Riassunto analitico
To assess the efficacy of percutaneous microwave ablation (MWA) of hepatocellular carcinoma (HCC) evaluating pathological examination after total hepatectomy in patients submitted to orthotopic liver transplantation (OLT).<br><br>Treatment outcomes were considered in 29 patients who underwent MWA for 31 HCC nodules and were subsequently submitted to OLT, between 2012 and 2017. Patients were submitted to MWA as a bridge therapy to OLT or before being included in the waiting list for OLT. Only nodules ≤40mm in size were considered eligible for MWA. Two experienced interventional radiologist performed MWA using a 2.45GHz system (HS AMICA®, HS HOSPITAL SERVICE SpA, Italy) with 14-gauge and 16-gauge antennas. <br><br>Nodule size ranged 12-40mm (23.9mm ± 7.9mm). All the nodules had complete radiological response at CT performed 1 month after treatment and at 3 months intervals thereafter. At pathology 21/31 (68%) nodules had complete necrosis (nodule size: 21.52mm ± 6.82 mm), while 10 nodules with complete radiological response had viable tumor at pathology. In 5/10 nodules with viable tumor the necrosis was &gt;90%. Of the 10 nodules &gt;3 cm, 6 were completely necrotised and 4 had necrosis &gt;90%. Mild significant correlation between nodule size and complete pathological response was found (p=0.003), with a linear relationship between antenna&#39;s caliber (14G) and complete pathological response.<br><br>Results of our studies confirmed the efficacy of MWA in treatment of HCC, even in nodules &gt;3cm. Compared to the results of radiofrequency ablation in published series with histopathological correlation, MWA seems to provide higher rates of complete necrosis. <br><br><br><br><br><br>
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