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Cancers
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Current Role of Ablation in Liver Cancer Therapy
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Current Role of Ablation in Liver Cancer Therapy

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (29 February 2024) | Viewed by 10996

Special Issue Editors

Prof. Dr. Alessandro Vitale

E-Mail Website
Guest Editor
Hepatobiliary and Liver Transplantation Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padova, Italy
Interests: hepatocellular carcinoma; hepatobiliary tumors; hepatobiliary surgery; liver transplantation; prognostic/staging systems
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Umberto Cillo

E-Mail Website
Guest Editor
Hepato-Biliary-Pancreatic and Liver Transplant Unit “Chirurgia Generale 2”, Padua University Hospital, 35128 Padova, Italy
Interests: transplantation; liver transplantation; surgery; hepatobiliary surgery; laparoscopic surgery; robotic HPB surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Ablation therapy is a well-recognized option among hepatocellular carcinoma (HCC) treatments. Since its introduction, it has progressively gained approval and it is nowadays included in the European, American and Asiatic HCC management guidelines as a reliable approach. Moreover, there is increasing evidence that ablation therapy could represent a potentially curative option also for other types of liver cancers (i.e., cholangiocarcinoma, colorectal or breast cancer liver metastases). Despite the improvements reached through the years, though, some innovations are still expected and desirable.

This Special Issue aims to explore the field of ablation in liver cancer therapy, examining innovative aspects and further developing poorly defined or already faced ones. A first scope is to collect additional evidence on the potential role of liver ablation for non-HCC liver cancers, such as cholangiocarcinoma, colorectal or breast cancer liver metastases. Furthermore, different ablation technologies, for example microwave rather than radiofrequency, are available and worth being compared. Other technical aspects like percutaneous or laparoscopic approach could also be addressed for useful comparisons. Innovative combination techniques with trans-arterial chemoembolization or immunotherapy are also recently being developed and studied.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following: extension of ablation indications to different types of liver cancers, technical and technological comparisons and innovations in this field.

We look forward to receiving your contributions.

Prof. Dr. Alessandro Vitale
Prof. Dr. Umberto Cillo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ablation
  • microwave
  • radiofrequency
  • percutaneous
  • laparoscopic
  • colorectal
  • breast
  • cancer
  • combination

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Published Papers (5 papers)

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Research

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14 pages, 1498 KiB  
Article
Usefulness of Body Position Change during Local Ablation Therapies for the High-Risk Location Hepatocellular Carcinoma
by Hitomi Takada, Yasuyuki Komiyama, Leona Osawa, Masaru Muraoka, Yuichiro Suzuki, Mitsuaki Sato, Shoji Kobayashi, Takashi Yoshida, Shinichi Takano, Shinya Maekawa and Nobuyuki Enomoto
Cancers 2024, 16(5), 1036; https://doi.org/10.3390/cancers16051036 - 3 Mar 2024
Viewed by 1118
Abstract
Local ablation therapies are important treatment options for early-stage hepatocellular carcinoma (HCC). Various techniques have been used to perform these therapies efficiently and safely. However, few reports have discussed the usefulness of body position change (BPC). This study aimed to investigate the usefulness [...] Read more.
Local ablation therapies are important treatment options for early-stage hepatocellular carcinoma (HCC). Various techniques have been used to perform these therapies efficiently and safely. However, few reports have discussed the usefulness of body position change (BPC). This study aimed to investigate the usefulness of BPC during local ablation therapies in patients with HCC. We evaluated 283 HCC nodules that underwent local ablation therapy. These nodules were categorized into high- or low-risk locations on the basis of their proximity to large vessels, adjacent extrahepatic organs, or poor visibility under ultrasound (US) guidance. The technical success rates, procedure time, and prognosis were evaluated. In this study, 176 (62%) nodules were classified in the high-risk location group. The high-risk location group was treated with techniques such as BPC, artificial pleural fluid, artificial ascites, fusion imaging, and contrast-enhanced US more frequently than the low-risk location group. The technical success rates were 96% and 95% for the high- and low-risk location groups, respectively. Within the high-risk location group, those without BPC had a lower success rate than those with BPC (91% vs. 99%, p = 0.015). Notably, BPC emerged as the sole contributing factor to the technical success rate in the high-risk location group (OR = 10, 95% CI 1.2–86, p = 0.034). In contrast, no differences were found in the procedure time, local tumor progression rates, intrahepatic distant recurrence rates, and overall survival between the groups with and without BPC in the high-risk location group. In conclusion, BPC during local ablation therapy in patients with HCC in high-risk locations was safe and efficient. The body position should be adjusted for HCC in high-risk locations to maintain good US visibility and ensure a safe puncture route in patients undergoing local ablation therapies. Full article
(This article belongs to the Special Issue Current Role of Ablation in Liver Cancer Therapy)
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18 pages, 3209 KiB  
Article
In Vivo Thermal Ablation of Deep Intrahepatic Targets Using a Super-Convergent MRgHIFU Applicator and a Pseudo-Tumor Model
by Orane Lorton, Pauline Coralie Guillemin, Andrea Peloso, Yacine M’Rad, Lindsey Alexandra Crowe, Thibaud Koessler, Pierre-Alexandre Poletti, Sana Boudabbous, Alexis Ricoeur and Rares Salomir
Cancers 2023, 15(15), 3961; https://doi.org/10.3390/cancers15153961 - 3 Aug 2023
Cited by 1 | Viewed by 1459
Abstract
Background: HIFU ablation of liver malignancies is particularly challenging due to respiratory motion, high tissue perfusion and the presence of the rib cage. Based on our previous development of a super-convergent phased-array transducer, we aimed to further investigate, in vivo, its applicability to [...] Read more.
Background: HIFU ablation of liver malignancies is particularly challenging due to respiratory motion, high tissue perfusion and the presence of the rib cage. Based on our previous development of a super-convergent phased-array transducer, we aimed to further investigate, in vivo, its applicability to deep intrahepatic targets. Methods: In a series of six pigs, a pseudo-tumor model was used as target, visible both on intra-operatory MRI and post-mortem gross pathology. The transcostal MRgHIFU ablation was prescribed coplanar with the pseudo-tumor, either axial or sagittal, but deliberately shifted 7 to 18 mm to the side. No specific means of protection of the ribs were implemented. Post-treatment MRI follow-up was performed at D7, followed by animal necropsy and gross pathology of the liver. Results: The pseudo-tumor was clearly identified on T1w MR imaging and subsequently allowed the MRgHIFU planning. The peak temperature at the focal point ranged from 58–87 °C. Gross pathology confirmed the presence of the pseudo-tumor and the well-delineated MRgHIFU ablation at the expected locations. Conclusions: The specific design of the transducer enabled a reliable workflow. It demonstrated a good safety profile for in vivo transcostal MRgHIFU ablation of deep-liver targets, graded as challenging for standard surgery. Full article
(This article belongs to the Special Issue Current Role of Ablation in Liver Cancer Therapy)
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20 pages, 11185 KiB  
Article
Microwave Catheter Navigation System for the Radiofrequency Liver Ablation
by Jakub Kollar, Tomas Drizdal, Jan Vrba, David Vrba, Tomas Pokorny, Marek Novak and Ondrej Fiser
Cancers 2022, 14(21), 5296; https://doi.org/10.3390/cancers14215296 - 27 Oct 2022
Cited by 2 | Viewed by 2116
Abstract
Thermal ablation is a well-known method used in interventional radiology to treat cancer. The treatment success is closely related to the exact catheter location in the treated area. Current navigation methods are based mostly on ultrasound or computed tomography. This work explores the [...] Read more.
Thermal ablation is a well-known method used in interventional radiology to treat cancer. The treatment success is closely related to the exact catheter location in the treated area. Current navigation methods are based mostly on ultrasound or computed tomography. This work explores the possibility of tracking the catheter position during ablation treatment of hepatocellular carcinomas (HCC) using an ultra-wideband (UWB) antenna array and microwave radar imaging based on the “Delay and Sum” (DAS) algorithm. The feasibility was first numerically studied on a simple homogeneous liver model. A heterogeneous anthropomorphic 3D model of the treated region consisting of the main organs within the treated area was then used. Various standard radiofrequency ablation (RFA) catheters were placed virtually in the heterogeneous model. The location and orientation of the antenna elements of the developed imaging system and the applied frequency band were studied. Subsequently, an experimental setup consisting of a 3D printed homogeneous anthropomorphic model, eight UWB dipole antennas, and catheters was created and used in a series of measurements. The average accuracy determining the catheter position from simulated and experimental data was 3.88 ± 0.19 and 6.13 ± 0.66 mm, which are close to the accuracy of clinical navigation systems. Full article
(This article belongs to the Special Issue Current Role of Ablation in Liver Cancer Therapy)
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Review

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13 pages, 3399 KiB  
Review
Laparoscopic Microwave Ablation: Which Technologies Improve the Results
by Roberto Santambrogio, Maurizio Vertemati, Matteo Barabino and Marco Antonio Zappa
Cancers 2023, 15(6), 1814; https://doi.org/10.3390/cancers15061814 - 17 Mar 2023
Cited by 5 | Viewed by 2258
Abstract
Liver resection is the best treatment for hepatocellular carcinoma (HCC) when resectable. Unfortunately, many patients with HCC cannot undergo liver resection. Percutaneous thermoablation represents a valid alternative for inoperable neoplasms and for small HCCs, but it is not always possible to accomplish it. [...] Read more.
Liver resection is the best treatment for hepatocellular carcinoma (HCC) when resectable. Unfortunately, many patients with HCC cannot undergo liver resection. Percutaneous thermoablation represents a valid alternative for inoperable neoplasms and for small HCCs, but it is not always possible to accomplish it. In cases where the percutaneous approach is not feasible (not a visible lesion or in hazardous locations), laparoscopic thermoablation may be indicated. HCC diagnosis is commonly obtained from imaging modalities, such as CT and MRI, However, the interpretation of radiological images, which have a two-dimensional appearance, during the surgical procedure and in particular during laparoscopy, can be very difficult in many cases for the surgeon who has to treat the tumor in a three-dimensional environment. In recent years, more technologies have helped surgeons to improve the results after ablative treatments. The three-dimensional reconstruction of the radiological images has allowed the surgeon to assess the exact position of the tumor both before the surgery (virtual reality) and during the surgery with immersive techniques (augmented reality). Furthermore, indocyanine green (ICG) fluorescence imaging seems to be a valid tool to enhance the precision of laparoscopic thermoablation. Finally, the association with laparoscopic ultrasound with contrast media could improve the localization and characteristics of tumor lesions. This article describes the use of hepatic three-dimensional modeling, ICG fluorescence imaging and laparoscopic ultrasound examination, convenient for improving the preoperative surgical preparation for personalized laparoscopic approach. Full article
(This article belongs to the Special Issue Current Role of Ablation in Liver Cancer Therapy)
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25 pages, 1610 KiB  
Review
Ablative Therapy in Non-HCC Liver Malignancy
by Tyler P. Robinson, Travis Pebror, Matthew E. Krosin and Leonidas G. Koniaris
Cancers 2023, 15(4), 1200; https://doi.org/10.3390/cancers15041200 - 14 Feb 2023
Cited by 1 | Viewed by 2712
Abstract
Surgical extirpation of liver tumors remains a proven approach in the management of metastatic tumors to the liver, particularly those of colorectal origin. Ablative, non-resective therapies are an increasingly attractive primary therapy for liver tumors as they are generally better tolerated and result [...] Read more.
Surgical extirpation of liver tumors remains a proven approach in the management of metastatic tumors to the liver, particularly those of colorectal origin. Ablative, non-resective therapies are an increasingly attractive primary therapy for liver tumors as they are generally better tolerated and result in far less morbidity and mortality. Ablative therapies preserve greater normal liver parenchyma allowing better post-treatment liver function and are particularly appropriate for treating subsequent liver-specific tumor recurrence. This article reviews the current status of ablative therapies for non-hepatocellular liver tumors with a discussion of many of the clinically available approaches. Full article
(This article belongs to the Special Issue Current Role of Ablation in Liver Cancer Therapy)
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