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Hepatic tumor ablation with clustered microwave antennae: the US Phase II trial.

ABSTRACT: BACKGROUND: Thermal ablation techniques have become important treatment options for patients with unresectable hepatic malignancies. Microwave ablation (MWA) is a new thermal ablative technique that uses electromagnetic energy to produce coagulation necrosis. We report outcomes from the first clinical trial in the United States using MWA and a 915 MHz generator. PATIENTS AND METHODS: Patients with unresectable primary or metastatic liver cancer were enrolled in a multi-institutional trial from March 2004 through May 2006. Demographic information, diagnosis, treatment, and outcomes were documented. RESULTS: Eighty-seven patients underwent 94 ablation procedures for 224 hepatic tumors. Forty-two ablations (45%) were performed open, 7 (7%) laparoscopically, and 45 (48%) percutaneously. The average tumor size was 3.6 cm (range 0.5-9.0 cm). Single antenna ablation volumes were 10.0 ml (range 7.8-14.0 ml), and clustered antennae ablation volumes were 50.5 ml (range 21.1-146.5 ml). Outcome variables were measured with a mean follow-up of 19 months. Local recurrence at the ablation site occurred in 6 (2.7%) tumors, and regional recurrence occurred in 37 (43%) patients. With a mean follow-up of 19 months, 41 (47%) patients were alive with no evidence of disease. There were no procedure-related deaths. The overall mortality rate was 2.3%. CONCLUSIONS: Microwave ablation is a safe and effective technology for hepatic tumor ablation. In our study, clustered antennae resulted in larger ablation volumes. Further studies with histological confirmation are needed to verify clinical results.

SUBMITTER: Iannitti DA

PROVIDER: S-EPMC2020783 | biostudies-other | 2007

REPOSITORIES: biostudies-other

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Microwave ablation of hepatic cyst: A case report.

Project description:Hepatic cystadenoma is an urgent problem due to the high risk of malignant transformation. There are both radical and minimally invasive methods of treatment. We present a clinical case describing the successful use of microwave ablation (MWA) in a 72-year-old woman with hepatic cystadenoma. The patient was admitted to the clinic with abdominal discomfort, dull pain in the right hypochondrium, and weight loss of 10 kg during the previous year. The patient had a past medical history of liver cyst in segment VII. Ultrasound scanning, computed tomography (CT) of abdominal organs detected an increase in the size of the cyst, heterogeneity of its structure; the contrast enhancement was noted in the cyst wall. We suspected hepatic cystadenoma in segment VII and performed cyst puncture under ultrasound control - the obtained fluid revealed the presence of cylindrical epithelial cells, mucin, and macrophages in large quantities, high telomerase activity, CA 19-9 levels were greater than 1000 U/mL. Surgery was accomplished using the MWA catheter. Biological and cytological examination of the fluid confirmed the presence of signs of liver cystadenoma with a high malignancy risk. On the 2nd day after surgery ultrasound imaging of the abdomen revealed the residual cavity of 2 × 1 cm in segment VII. The patient was discharged with recommendations to conduct ultrasound examinations every six months. The control CT scan in 2020 showed no focal or cystic formations in the liver. In what way, MWA under control of ultrasound is a promising method of biliary cystadenoma treatment with high malignancy risk.

| S-EPMC7750443 | biostudies-literature

Predictors of thrombosis in hepatic vasculature during microwave tumor ablation of an in vivo porcine model.

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| S-EPMC4253571 | biostudies-literature

Microwave versus radiofrequency ablation for the treatment of liver malignancies: a randomized controlled phase 2 trial.

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| S-EPMC8748896 | biostudies-literature

Microwave ablation enhances tumor-specific immune response in patients with hepatocellular carcinoma.

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| S-EPMC7979675 | biostudies-literature

A Phase II Study of Tumor Ablation in Patients with Metastatic Sarcoma Stable on Chemotherapy.

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| S-EPMC6058323 | biostudies-literature

Safety and effective of laparoscopic microwave ablation for giant hepatic hemangioma: A retrospective cohort study.

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| S-EPMC6411492 | biostudies-literature

Laparoscopic radiofrequency fibroid ablation: phase II and phase III results.

Project description:BACKGROUND AND OBJECTIVES:To review phase II and phase III treatments of symptomatic uterine fibroids (myomas) using laparoscopic radiofrequency volumetric thermal ablation (RFVTA). METHODS:We performed a retrospective, multicenter clinical analysis of 206 consecutive cases of ultrasound-guided laparoscopic RFVTA of symptomatic myomas conducted on an outpatient basis under two phase II studies at 2 sites (n = 69) and one phase III study at 11 sites (n = 137). Descriptive and exploratory, general trend, and matched-pair analyses were applied. RESULTS:From baseline to 12 months in the phase II study, the mean transformed symptom severity scores improved from 53.9 to 8.8 (P < .001) (n = 57), health-related quality-of-life scores improved from 48.5 to 92.0 (P < .001) (n = 57), and mean uterine volume decreased from 204.4 cm(3) to 151.4 cm(3) (P = .008) (n = 58). Patients missed a median of 4 days of work (range, 2-10 days). The rate of possible device-related adverse events was 1.4% (1 of 69). In the phase III study, approximately 98% of patients were assessed at 12 months, and their transformed symptom severity scores, health-related quality-of-life scores, mean decrease in uterine volume, and mean menstrual bleeding reduction were also significant. Patients in phase III missed a median of 5 days of work (range, 1-29 days). The rate of periprocedural device-related adverse events was 3.5% (5 of 137). Despite the enrollment requirement for patients in both phases to have completed childbearing, 4 pregnancies occurred within the first year after treatment. CONCLUSIONS:RFVTA does not require any uterine incisions and provides a uterine-sparing procedure with rapid recovery, significant reduction in uterine size, significant reduction or elimination of myoma symptoms, and significant improvement in quality of life.

| S-EPMC4035627 | biostudies-literature

Zero ischemia laparoscopic microwave ablation assisted enucleation vs. laparoscopic partial nephrectomy in clinical T1a renal tumor: a randomized clinical trial

Project description:Background The study aims to evaluate efficiency, safety and the functional outcomes of zero ischemia laparoscopic microwave ablation assisted tumor enucleation (LMWATE) in comparison with laparoscopic partial nephrectomy (LPN) for cT1a renal tumors. Methods A prospective randomized controlled trial on cT1a renal tumor patients treated by laparoscopic nephron sparing surgeries between October 2014 to September 2017 was conducted. Tumor enucleation was performed in the LMWATE group after microwave ablation (MWA) without hilar clamping. The endpoint was the affected kidney’s change of GFR measured by renal scintigraphy at the 3rd month and 12th month postoperatively. All the patients were followed up for at least 12 months. The Student t-test, Wilcoxon rank sum tests and Pearson Chi-square or Fisher exact were applied to analyse data. Results The number of patients enrolled in the LMWATE group and LPN group were 90 and 93 respectively. Patients in the LPN group showed much more decline of effect kidney glomerular filtration rate at 3 months (10.3 vs. 17.4, P<0.001) and 12 months postoperatively (8.8 vs. 10.2, P=0.023) when compared to the LMWATE group. Additionally, in the LMWATE group, considerably shorter median operation duration (91 vs. 112 minutes, P<0.001), lower median estimated blood loss (82.5 vs. 117.5 mL, P<0.001) and shorter hospital stay (5.5 vs. 6 days, P=0.013) were observed but with similar postoperative complications in both groups. There was no positive margin or local recurrence in both groups. Conclusions Zero ischemia LMWATE may provide better preservation of renal function, decrease operative time and blood loss compared to LPN with similar complication rates.

| S-EPMC8798795 | biostudies-literature

Microwave ablation in a hepatic porcine model: correlation of CT and histopathologic findings.

Project description:BACKGROUND: Thermal ablative techniques have gained increasing popularity in recent years as safe and effective options for patients with unresectable solid malignancies. Microwave ablation has emerged as a relatively new technique with the promise of larger and faster burns without some of the limitations of radiofrequency ablation (RFA). Here we study a new microwave ablation device in a living porcine model using gross, histologic, and radiographic analysis. MATERIALS AND METHODS: The size and shape of ablated lesions were assessed using six pigs in a non-survival study. Liver tissue was ablated using 2, 4, and 8 min burns, in both peripheral and central locations, with and without vascular inflow occlusion. To characterize the post-ablation appearance, three additional pigs underwent several 4 min ablations each followed by serial computed tomography (CT) imaging at 7, 14, and 28 days postoperatively. RESULTS: The 2 and 4 min ablations resulted in lesions that were similar in size, 33.5 cm(3) and 37.5 cm(3), respectively. Ablations lasting 8 min produced lesions that were significantly larger, 92.0 cm(3) on average. Proximity to hepatic vasculature and inflow occlusion did not significantly change lesion size or shape. In follow-up studies, CT imaging showed a gradual reduction in lesion volume over 28 days to 25-50% of the original volume. DISCUSSION: Microwave ablation with a novel device results in consistently sized and shaped lesions. Importantly, we did not observe any significant heat-sink effect using this device, a major difference from RFA techniques. This system offers a viable alternative for creating fast, large ablation volumes for treatment in liver cancer.

| S-EPMC2225513 | biostudies-other

TIGIT Blockade Exerts Synergistic Effects on Microwave Ablation against Cancer

Project description:Combination immunotherapy based on immune checkpoint inhibitors (ICIs) has shown great success in the treatment of many types of cancers and has become the mainstream in the comprehensive treatment of cancers. Ablation in combination with immunotherapy has achieved tremendous efficacy in some preclinical and clinical studies. To date, our team proved that ablation in combination with ICIs was a promising antitumor therapeutic strategy for the liver metastasis of colorectal cancer (CRC). Moreover, we found that the expression of T cell immunoglobulin and immunoreceptor tyrosine-based inhibitory motif domain (TIGIT) expression was up-regulated after microwave ablation (MWA), indicating that TIGIT was involved in immunosuppression, and the combination of MWA and TIGIT blockade represented a potential clinical treatment strategy. In this study, we analyzed the single-cell RNA sequencing (scRNA-seq) data from the MWA and MWA plus anti-TIGIT groups. We found that TIGIT blockade in combination with MWA significantly promoted the expansion and functions of CD8+ TILs and reshaped myeloid cells in the tumor microenvironment (TME). In conclusion, TIGIT blockade in combination with MWA was a novel treatment strategy for the liver metastasis of CRC, and this combination therapy could reprogram the TME toward an antitumor environment.

2022-03-30 | GSE194209 | GEO

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