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May 20, 2020

Austrian Study Supports Simultaneous Stereotactic RF Ablation to Manage Multiple Liver Tumors

May 20, 2020—Simultaneous stereotactic radiofrequency ablation (SRFA) was shown to be a “feasible, safe, and efficacious option” for the simultaneous management of multiple primary and metastatic liver tumors in a study by Peter Schullian, MD, et al published in the June edition of Journal of Vascular and Interventional Radiology (JVIR; 2020;31:943–952). The investigators, led by Professor Reto Bale, MD, are from the Section of Interventional Oncology–Microinvasive Therapy (SIP: Stereotaxy, Intervention, and Planning) in the Department of Radiology at the Medical University of Innsbruck in Innsbruck, Austria.

The findings were summarized in the JVIR study abstract. In comments to Endovascular Today, Prof. Bale expanded on the abstract data and commented, “Despite the complexity of the procedures due to the inclusion of very large lesions and a large number of lesions per session, simultaneous SRFA of multiple liver tumors can be accomplished with excellent technical efficacy, local control, and overall clinical outcome. The results seem to justify specialized training in stereotaxy as well as the additional costs related to the requirements of infrastructure and staff.”

The retrospective observational study was composed of 92 patients (29 women, 62 men) treated with SRFA between 2005 and 2018. At the initial SRFA, the patient and tumor characteristics included the following:

  • Thirty-five patients with ≥ 4 (median 5; range 4–9) hepatocellular carcinomas (HCCs)
  • Fifty-seven patients with ≥ 4 (median 5; range 4–12) metastatic liver tumors
  • The median size of 178 HCCs was 2.2 cm (range, 1–8.5 cm)
  • The median size of 371 metastases was 3 cm (range, 0.5–13 cm)

In the HCC and metastases patients, respectively, at the initial SRFA: 17 (48.6%) and 19 (33.3%) had four tumors; 11 (31.4%) and 19 (33.3%) had five tumors; and seven (20%) and 19 (33.3%) had six or more tumors.

The investigators reported:

  • Major complications occurred in nine (8.4%) of 107 ablations
  • Seven of nine major complications were successfully treated by the interventional radiologist in the same anesthesia session by the placement of a thoracostomy tube or transarterial embolization
  • Local recurrence was observed in four (2.2%) of 178 HCCs
  • Local recurrence was observed in 17 (4.6%) of 371 metastases

Overall survival (OS) rates at 1, 3, and 5 years, respectively, from the date of the first SRFA, were:

  • 88%, 54%, and 30.4% for patients with HCCs with a median OS of 38.2 months
  • 86.1%, 53.1%, and 37.3% for patients with metastases with a median OS of 37.4 months

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May 21, 2020

COVID-19 Shown to Cause Severe Vascular Damage by Invading Endothelial Cells

May 20, 2020

Relation of SARS2-CoV-2 and Stroke Evaluated in Patients in a New York Health Care System