Viable Tumor Tissue Adherent to Needle Applicators after Local Ablation: A Risk Factor for Local Tumor ProgressionReport as inadecuate




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Annals of Surgical Oncology

, Volume 18, Issue 13, pp 3702–3710

First Online: 18 May 2011Received: 09 June 2010

Abstract

BackgroundLocal tumor progression LTP is a serious complication after local ablation of malignant liver tumors, negatively influencing patient survival. LTP may be the result of incomplete ablation of the treated tumor. In this study, we determined whether viable tumor cells attached to the needle applicator after ablation was associated with LTP and disease-free survival.

MethodsIn this prospective study, tissue was collected of 96 consecutive patients who underwent local liver ablations for 130 liver malignancies. Cells and tissue attached to the needle applicators were analyzed for viability using glucose-6-phosphate-dehydrogenase staining and autofluorescence intensity levels of HandE stained sections. Patients were followed-up until disease progression.

ResultsViable tumor cells were found on the needle applicators after local ablation in 26.7% of patients. The type of needle applicator used, an open approach, and the omission of track ablation were significantly correlated with viable tumor tissue adherent to the needle applicator. The presence of viable cells was an independent predictor of LTP. The attachment of viable cells to the needle applicators was associated with a shorter time to LTP.

ConclusionsViable tumor cells adherent to the needle applicators were found after ablation of 26.7% of patients. An independent risk factor for viable cells adherent to the needle applicators is the omission of track ablation. We recommend using only RFA devices that have track ablation functionality. Adherence of viable tumor cells to the needle applicator after local ablation was an independent risk factor for LTP.

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Author: Nikol Snoeren - Joost Huiskens - Arjen M. Rijken - Richard van Hillegersberg - Arian R. van Erkel - Gerrit D. Slooter -

Source: https://link.springer.com/article/10.1245/s10434-011-1762-8



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