Is Percutaneous Thermal Ablation Safe and Effective for Hepatocellular Adenomas?
Percutaneous thermal ablation for hepatocellular adenomas is safe and effective, according to a study published in Cardiovascular and Interventional Radiology.
Hepatocelluar adenomas are benign neoplasms, though they pose a risk of hemorrhage or malignant transformation. Management options include discontinuing oral contraceptives, surgical resection, or arterial embolization. Although percutaneous thermal ablation is typically used for hepatocellular carcinoma, it may be an option for hepatocellular adenomas as well.
For this study, the researchers retrospectively evaluated data from 36 patients who had 44 percutaneous thermal ablation procedures that treated 58 pathologically proven hepatocellular adenomas. The patients had a median age of 35 years and were treated at a tertiary referral center from 1999 to 2016. Post-procedural imaging was used to assess the efficacies of primary and secondary techniques.
Patients had a median tumor size of 2.1 cm, with a range of 0.6 to 6.0 cm. There was a prior history of adenoma-related hemorrhage in 22% of patients.
Most treatments were performed in an outpatient setting and used radiofrequency ablation guided by ultrasound. Patients received moderate sedation, and the procedures lasted a median of 85 minutes.
Following the procedures, there were two immediate hemorrhages (4.5% per procedure). Patients were followed for a median of 1.7 years, during which there was no malignant transformation, adenoma-related hemorrhages, or deaths. Primary technique efficacy was calculated as 88% and secondary technique as 100%.
“In conclusion, thermal ablation performed for the treatment of hepatocellular adenomas has a similar complication rate to surgery and embolization. Since the primary application of thermal ablation is for smaller tumors (< 5 cm), future studies with comparison to conservative management are needed,” the authors stated.
Mironov O, Jaberi A, Beecroft R, Kachura JR. Retrospective single-arm cohort study of patients with hepatocellular adenomas treated with percutaneous thermal ablation. Cardiovasc Intervent Radiol. 2018 Feb 7. doi: 10.1007/s00270-018-1893-4. [Epub ahead of print].