Tesi etd-12192021-150013 |
Link copiato negli appunti
Tipo di tesi
Tesi di specializzazione (4 anni)
Autore
CAMPANA, FRANCESCO
URN
etd-12192021-150013
Titolo
Percutaneous thermal segmentectomy: proof of concept
Dipartimento
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
RADIODIAGNOSTICA
Relatori
relatore Prof. Neri, Emanuele
relatore Prof.ssa Crocetti, Laura
relatore Prof.ssa Crocetti, Laura
Parole chiave
- b-TACE
- balloon-occluded microwave ablation (b-MWA)
- hepatocellular carcinoma (HCC)
- intrahepatic cholangiocarcinoma (iCC)
- liver colorectal metastasis (mCRC)
Data inizio appello
15/01/2022
Consultabilità
Non consultabile
Data di rilascio
15/01/2092
Riassunto
Purpose: to report the multicentre retrospective experience on combination of balloon-occluded MWA(b-MWA) followed by balloon-occluded TACE(b-TACE) in patients with liver malignancies >3 cm, focusing on appearance and volume of necrotic area, safety profile and oncological results.
Materials and Methods: twenty-three patients with primary liver malignancies(HCC=18; iCC=2) and liver metastasis (mCRC=1; sarcoma metastasis=1; breast metastasis=1) were treated. Maximum mean diameter of lesions was 43,48 mm(±9,49).
Treatments were performed in a single-step approach.
Necrotic area shape (spherical, oval, irregular, triangular) and discrepancy with the expected volume of necrosis suggested by vendor’s ablation chart were assessed at post-procedural CT.
Complications were categorized according to CIRSE classification.
Oncological results at 1 and 3–6 months were evaluated using m-RECIST(HCC) and RECISTv1.1(metastasis/iCC).
Results: mean maximum volume of necrotic area was 75,01cm3(±36,04).
Discrepancy with vendor chart consisted in a medium percentage of volumetric incrementation of necrotic area of 103,2%(± 99,78). Not spherical shape was observed in 22/23 patients (95,65%).
According to CIRSE classification, no complications occurred; Post-embolization syndrome occurred in 12/23 patients.
Complete response at 1 and 3–6 months was 91,3%(21/23) and 87,5%(14/16). Partial response at 1 and 3–6 months was 8,7%(2/23) and 12,5%(2/16). Among partial responder, average percentage of tumour volume debulking was 78,83%(±9,77%).
Conclusion: b-MWA followed by b-TACE in a single-step lead to a larger not 36 spherical necrotic area, corresponding to the occluded vascular segment during ablation. This permitted safely to achieve promising oncological results in patients with >3 cm tumors.
Materials and Methods: twenty-three patients with primary liver malignancies(HCC=18; iCC=2) and liver metastasis (mCRC=1; sarcoma metastasis=1; breast metastasis=1) were treated. Maximum mean diameter of lesions was 43,48 mm(±9,49).
Treatments were performed in a single-step approach.
Necrotic area shape (spherical, oval, irregular, triangular) and discrepancy with the expected volume of necrosis suggested by vendor’s ablation chart were assessed at post-procedural CT.
Complications were categorized according to CIRSE classification.
Oncological results at 1 and 3–6 months were evaluated using m-RECIST(HCC) and RECISTv1.1(metastasis/iCC).
Results: mean maximum volume of necrotic area was 75,01cm3(±36,04).
Discrepancy with vendor chart consisted in a medium percentage of volumetric incrementation of necrotic area of 103,2%(± 99,78). Not spherical shape was observed in 22/23 patients (95,65%).
According to CIRSE classification, no complications occurred; Post-embolization syndrome occurred in 12/23 patients.
Complete response at 1 and 3–6 months was 91,3%(21/23) and 87,5%(14/16). Partial response at 1 and 3–6 months was 8,7%(2/23) and 12,5%(2/16). Among partial responder, average percentage of tumour volume debulking was 78,83%(±9,77%).
Conclusion: b-MWA followed by b-TACE in a single-step lead to a larger not 36 spherical necrotic area, corresponding to the occluded vascular segment during ablation. This permitted safely to achieve promising oncological results in patients with >3 cm tumors.
File
| Nome file | Dimensione |
|---|---|
Tesi non consultabile. |
|