Universität zu Köln

Stippel, D. L., Wahba, R., Bruns, C. J., Bunck, A., Baues, C. and Persigehl, T. (2018). Image-guided, minimally invasive surgery and other local therapeutic procedures for primary liver tumors. Chirurg, 89 (11). S. 872 - 880. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0385

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Abstract

BackgroundThe incidence of primary liver tumors is rising. Modern minimally invasive, image-guided procedures offer apotentially curative therapy option.ObjectiveThe aim of this study was to evaluate the multitude of image-guided minimally invasive procedures concerning their evidence-based effect on local tumor control and overall survival.Material and methodsAsystematic search of MEDLINE focused on hepatocellular cancer, minimally invasive treatment, local ablative therapy, therapeutic stratification and comparative studies was performed.ResultsThe level of evidence varied greatly depending on the procedure used. The highest quality evidence including prospective randomized studies was found for radiofrequency ablation (RFA) of hepatocellular cancer. The RFA is superior with respect to local tumor control and overall survival in comparison to other ablative procedures. Prospective randomized studies comparing surgery and RFA showed diverging and contradictory results. Microwave ablation and robotic stereotactic irradiation showed sufficient potential in retrospective studies in comparison to RFA and surgery in order to confirm the techniques in randomized studies. There is only anecdotal evidence concerning high intensity focused ultrasound (HIFU) and irreversible electroporation. Percutaneous ethanol injection(PEI), cryoablation and laser-induced thermal therapy (LITT) were inferior techniques to RFA in most studies.ConclusionMinimally invasive resection and local ablative therapies based on structured imaging and image reporting can improve the prognosis of patients with hepatocellular cancer even in patients that exceed the BCLC0/A stage.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Stippel, D. L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahba, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, C. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bunck, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Baues, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Persigehl, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-166758
DOI:	10.1007/s00104-018-0688-0
Journal or Publication Title:	Chirurg
Volume:	89
Number:	11
Page Range:	S. 872 - 880
Date:	2018
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0385
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SMALL HEPATOCELLULAR-CARCINOMA; BODY RADIATION-THERAPY; RADIOFREQUENCY ABLATION; HEPATIC RESECTION; METAANALYSIS; SURVIVAL; CIRRHOSIS Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16675