- Email: [email protected]
Radiofrequency ablation for liver tumors: our experience
21ST ANNUAL CONFERENCE—2013
ABSTRACTS
a 22% and 43% decrease in the QLQ-C30 score was observed in each group respectively. Conclusion: Nexavar administration has shown to improve the survival and quality of life in cirrhotic, stage AB, Greek patients with advanced HCC.
Conclusion: Our study concluded that multidisciplinary approach to hepatoblastoma is justified as it decreases the resection margin, increase tolerance to surgery, decrease morbidity and improves the outcome of patient. Serum Alfa Feto Protein is a good prognostic indicator.
Corresponding author: Dimitrios Dimitroulopoulos. E-mail: [email protected]
Corresponding author: Gururaj Deshpande. E-mail: [email protected]
HEPATOBLASTOMA: MULTIDISCPLINARY MANAGEMENT AND OUR EXPERIENCE
EMERGENCY HEPATIC RESECTION: A LIFE SAVING PROCEDURE IN RUPTURED HEPATOBLASTOMA: A RARE CASE REPORT
Gururaj Deshpande, Sudhir Chandana, Sumit Kumar, Vijay Yadav, Sudhir Das
Gururaj Deshpande, Devendra Parikh, Mahesh D. Patel
Hepatocellular Carcinoma
Gujarat Cancer and Research Institute (GCRI), Ahmedabad, India
Gujarat Cancer and Research Institute (GCRI), Ahmedabad, India
Introduction: Hepatoblastoma is the most common liver tumor in children and comprise of 79% of all liver tumor in children. Its incidence is 1.5 per million and it constitutes 1% of all paediatric malignancies. Surgical techniques and adjuvant chemotherapy have markedly improved the prognosis of children with Hepatoblastoma. Significant data now support a role for preoperative neoadjuvant chemotherapy if the tumor is inoperable or if the tumor is unlikely to achieve gross total resection at initial diagnosis. Liver is playing an increasing role in cases in which the tumor is deemed unresectable after chemotherapy is administered or in "rescue" transplantation when initial surgery and chemotherapy are not successful. Rarely hepatoblastoma has presented with rupture, hemoperitonuem and shock. We would also discuss about how we managed a case of ruptured hepatoblastoma. Method: This is a retrospective Study of 30 patients of hepatoblastoma at our centre in last 10 years from 2001-2011.Their presentation, prevalence, treatment offered - surgical and medical, complications and follow up were analysed. Median age of presentation in our study was 38.3 month with M:F ratio of 1.72:1.Neoadjuvant chemotherapy was given in 26 out of 30 patients in the form of Cisplatin + Adriamycin and reassessment was done after 1-3 cycles. In case of inadequate response maximum of 6 cycles were given. Each Patient was assigned PRETEXT stage I-IV. Almost every patient received chemotherapy pre operatively &/or post operatively. After 3 cycles if the tumour was found inoperable a few more cycles are given maximum of 6 cycles and the patient was reviewed again. Follow up is completed up to October 2012 and results were analysed by Kaplan-Meier method. Patient with ruptured tumor with hemoperitonuem and shock was resuscitated and was taken up for emergency hepatic resection in the form of right hepatectomy. Results: Follow up varied from 6 months – 114 months with a mean follow up is 25.8 months. Survival at 2 year is 96.3%.
Hepatoblastoma is the most common primary hepatic tumor of children. However, only a very few cases have been reported in adults. Most studies support treatment with chemotherapy followed by surgical resection. We present the first reported survival of paediatric ruptured hepatoblastoma in India. A seven year-old boy suffered from sudden onset of abdominal pain and general weakness progressing to shock. Internal bleeding leading to hemorrhagic shock was suspected on abdominal imaging due to a mass lesion in the right lobe of liver. Patient underwent emergency exploratory laparotomy and hepatic resection. Right hepatectomy was performed with successful outcome. Final histopathology was reported as mixed hepatoblastoma.
S106
Corresponding author: Gururaj Deshpande. E-mail: [email protected]
RADIOFREQUENCY ABLATION FOR LIVER TUMORS: OUR EXPERIENCE Naresh Kumar Bansal,1 Arun Gupta,2 Vikash Singla,1 Praveen Sharma,1 Ajit Yadav,2 Pankaj Tyagi,1 Ashish Kumar,1 Anil Arora1 1
Department of Gastroenterology & Hepatology, Sir Ganga Ram Hospital, New Delhi, 2Department of Interventional Radiology, Sir Ganga Ram Hospital, New Delhi
Background and Aims: The majority of patients with primary or metastatic hepatic tumors are not candidates for resection. Radiofrequency ablation (RFA) is used to treat patients with unresectable primary and metastatic hepatic cancers and is gaining popularity as the ablative therapy of choice for liver tumors. RFA produces coagulative necrosis of tumor through local tissue heating. Liver tumors are treated percutaneously, laparoscopically, or during laparotomy using ultrasonography to identify tumors and guide placement of the RFA needle electrode.
© 2013, INASL
JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY
Hepatocellular Carcinoma
Methods: All patients who underwent radiofrequency ablation for primary or metastatic liver tumors from June 2005- June 2012 (5 years) at Sir Ganga Ram Hospital, New Delhi, were included. RITA medical Systems (Mountain View, California, USA) machine was used for RFA. All procedures were carried out under ultrasound guidance by single operator. Results: Total 48 cycles were done in 39 (28 males, 11 females) patients. Four patients underwent RFA procedures 2 times while 2 patients underwent these 3 times. Hepatitis B was the most common cause of liver cancer while colorectal carcinoma was leading cause of metastatic tumors. Fourty three cycles were done percutaneously and rest 5 were done during laparotomy. Median tumor size was 2.8 cms (range 1- 4 cms) and median age of patient was 56 years. Successful ablation was achieved in all patients with hepatic metastasis less than 3 cm in size. Pain was the most common (70%) complication, two patients developed skin burns. Median follow up was 18 months (3- 48 months). One year survival was 62% while tumor recurrence was seen in 4 (10%) patients. Discussion: In general, RFA is a safe, well-tolerated and effective treatment for unresectable hepatic malignancies and liver metastasis of less than 3 cm in diameter. Details will be discussed. Corresponding author: Naresh Kumar Bansal. E-mail: [email protected]
Journal of Clinical and Experimental Hepatology | March 2013 | Vol. 3 | No. 1S | S101–S107
S107
ABSTRACTS
a 22% and 43% decrease in the QLQ-C30 score was observed in each group respectively. Conclusion: Nexavar administration has shown to improve the survival and quality of life in cirrhotic, stage AB, Greek patients with advanced HCC.
Conclusion: Our study concluded that multidisciplinary approach to hepatoblastoma is justified as it decreases the resection margin, increase tolerance to surgery, decrease morbidity and improves the outcome of patient. Serum Alfa Feto Protein is a good prognostic indicator.
Corresponding author: Dimitrios Dimitroulopoulos. E-mail: [email protected]
Corresponding author: Gururaj Deshpande. E-mail: [email protected]
HEPATOBLASTOMA: MULTIDISCPLINARY MANAGEMENT AND OUR EXPERIENCE
EMERGENCY HEPATIC RESECTION: A LIFE SAVING PROCEDURE IN RUPTURED HEPATOBLASTOMA: A RARE CASE REPORT
Gururaj Deshpande, Sudhir Chandana, Sumit Kumar, Vijay Yadav, Sudhir Das
Gururaj Deshpande, Devendra Parikh, Mahesh D. Patel
Hepatocellular Carcinoma
Gujarat Cancer and Research Institute (GCRI), Ahmedabad, India
Gujarat Cancer and Research Institute (GCRI), Ahmedabad, India
Introduction: Hepatoblastoma is the most common liver tumor in children and comprise of 79% of all liver tumor in children. Its incidence is 1.5 per million and it constitutes 1% of all paediatric malignancies. Surgical techniques and adjuvant chemotherapy have markedly improved the prognosis of children with Hepatoblastoma. Significant data now support a role for preoperative neoadjuvant chemotherapy if the tumor is inoperable or if the tumor is unlikely to achieve gross total resection at initial diagnosis. Liver is playing an increasing role in cases in which the tumor is deemed unresectable after chemotherapy is administered or in "rescue" transplantation when initial surgery and chemotherapy are not successful. Rarely hepatoblastoma has presented with rupture, hemoperitonuem and shock. We would also discuss about how we managed a case of ruptured hepatoblastoma. Method: This is a retrospective Study of 30 patients of hepatoblastoma at our centre in last 10 years from 2001-2011.Their presentation, prevalence, treatment offered - surgical and medical, complications and follow up were analysed. Median age of presentation in our study was 38.3 month with M:F ratio of 1.72:1.Neoadjuvant chemotherapy was given in 26 out of 30 patients in the form of Cisplatin + Adriamycin and reassessment was done after 1-3 cycles. In case of inadequate response maximum of 6 cycles were given. Each Patient was assigned PRETEXT stage I-IV. Almost every patient received chemotherapy pre operatively &/or post operatively. After 3 cycles if the tumour was found inoperable a few more cycles are given maximum of 6 cycles and the patient was reviewed again. Follow up is completed up to October 2012 and results were analysed by Kaplan-Meier method. Patient with ruptured tumor with hemoperitonuem and shock was resuscitated and was taken up for emergency hepatic resection in the form of right hepatectomy. Results: Follow up varied from 6 months – 114 months with a mean follow up is 25.8 months. Survival at 2 year is 96.3%.
Hepatoblastoma is the most common primary hepatic tumor of children. However, only a very few cases have been reported in adults. Most studies support treatment with chemotherapy followed by surgical resection. We present the first reported survival of paediatric ruptured hepatoblastoma in India. A seven year-old boy suffered from sudden onset of abdominal pain and general weakness progressing to shock. Internal bleeding leading to hemorrhagic shock was suspected on abdominal imaging due to a mass lesion in the right lobe of liver. Patient underwent emergency exploratory laparotomy and hepatic resection. Right hepatectomy was performed with successful outcome. Final histopathology was reported as mixed hepatoblastoma.
S106
Corresponding author: Gururaj Deshpande. E-mail: [email protected]
RADIOFREQUENCY ABLATION FOR LIVER TUMORS: OUR EXPERIENCE Naresh Kumar Bansal,1 Arun Gupta,2 Vikash Singla,1 Praveen Sharma,1 Ajit Yadav,2 Pankaj Tyagi,1 Ashish Kumar,1 Anil Arora1 1
Department of Gastroenterology & Hepatology, Sir Ganga Ram Hospital, New Delhi, 2Department of Interventional Radiology, Sir Ganga Ram Hospital, New Delhi
Background and Aims: The majority of patients with primary or metastatic hepatic tumors are not candidates for resection. Radiofrequency ablation (RFA) is used to treat patients with unresectable primary and metastatic hepatic cancers and is gaining popularity as the ablative therapy of choice for liver tumors. RFA produces coagulative necrosis of tumor through local tissue heating. Liver tumors are treated percutaneously, laparoscopically, or during laparotomy using ultrasonography to identify tumors and guide placement of the RFA needle electrode.
© 2013, INASL
JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY
Hepatocellular Carcinoma
Methods: All patients who underwent radiofrequency ablation for primary or metastatic liver tumors from June 2005- June 2012 (5 years) at Sir Ganga Ram Hospital, New Delhi, were included. RITA medical Systems (Mountain View, California, USA) machine was used for RFA. All procedures were carried out under ultrasound guidance by single operator. Results: Total 48 cycles were done in 39 (28 males, 11 females) patients. Four patients underwent RFA procedures 2 times while 2 patients underwent these 3 times. Hepatitis B was the most common cause of liver cancer while colorectal carcinoma was leading cause of metastatic tumors. Fourty three cycles were done percutaneously and rest 5 were done during laparotomy. Median tumor size was 2.8 cms (range 1- 4 cms) and median age of patient was 56 years. Successful ablation was achieved in all patients with hepatic metastasis less than 3 cm in size. Pain was the most common (70%) complication, two patients developed skin burns. Median follow up was 18 months (3- 48 months). One year survival was 62% while tumor recurrence was seen in 4 (10%) patients. Discussion: In general, RFA is a safe, well-tolerated and effective treatment for unresectable hepatic malignancies and liver metastasis of less than 3 cm in diameter. Details will be discussed. Corresponding author: Naresh Kumar Bansal. E-mail: [email protected]
Journal of Clinical and Experimental Hepatology | March 2013 | Vol. 3 | No. 1S | S101–S107
S107