https://orcid.org/0000-0003-0021-5792
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Abstract
Background and aims
Surgical resection is currently the cornerstone of liver tumor treatment in children. In adults radiofrequency ablation (RFA) is an established minimally invasive treatment option for small focal liver tumors. Multiprobe stereotactic RFA (SRFA) with intraoperative image fusion to confirm ablation margins allows treatment for large lesions. We describe our experience with SRFA in children with liver masses.
Methods
SRFA was performed in 10 patients with a median age of 14 years (range 0.5–17.0 years) suffering from liver adenoma (n = 3), hepatocellular carcinoma (n = 1), hepatoblastoma (n = 2), myofibroblastic tumor (n = 1), hepatic metastases of extrahepatic tumors (n = 2) and infiltrative hepatic cysts associated with alveolar echinococcosis (n = 1). Overall, 15 lesions with a mean lesion size of 2.6 cm (range 0.7–9.5 cm) were treated in 11 sessions.
Results
The technical success rate was 100%, as was the survival rate. No transient adverse effects higher than grade II (Clavien and Dindo) were encountered after interventions. The median hospital stay was 5 d (range 2–33 d). In two patients who subsequently underwent transplant hepatectomy complete ablation was histologically confirmed. Follow-up imaging studies (median 55 months, range 18–129 months) revealed no local or distant recurrence of disease in any patient.
Conclusions
SRFA is an effective minimal-invasive treatment option in pediatric patients with liver tumors of different etiologies.
Acknowledgment
We thank A.S. Knisely, Institute of Pathology, Medical University of Graz, Graz, Austria, for histopathologic and editorial consultation. This study was presented in part at the 50th ESPGHAN Annual Meeting in Prague, 15 March 2017.
What is already known on this topic
RFA is a minimally invasive and potentially curative treatment option for liver lesions. SRFA generates overlapping ablations for effective and safe treatment of large tumors in adults.
What this study adds
SRFA seems to be effective minimal invasive treatment option in pediatric patients with liver tumors of different etiologies.
Author contributions
H.B., V.G.F., H.M., M.T. and B.R. designed the study, analyzed the data and wrote the manuscript. B.R. developed stereotactic radiofrequency ablation (SRFA). B.R., S.P. and P.D. performed the described interventions. O.G. performed histopathological analysis and TUNEL assays. K.G., M.B., C.R., K.D., M.T., S.C., E.A., S.S., N.C., C.G., J.A., F.K., M.K., S.G., R.O., S.S. and R.B. were involved in patient care, contributed to the manuscript and contributed to editing.
Disclosure statement
No potential conflict of interest was reported by the author(s).