title: Combined therapies for the treatment of technically unresectable liver malignancies: bland embolization and radiofrequency thermal ablation within the same session.
abstract: OBJECTIVE
  This retrospective study evaluated the feasibility, efficacy, and safety of combining transcatheter arterial embolization (TAE) with radiofrequency thermal ablation (RFA) in a single session for the treatment of technically unresectable liver-only malignancies.
  
  
  METHODS
  From May 2006 to January 2011, a total of 30 patients affected by liver metastases with single or multiple unresectable liver-only lesions underwent a combined treatment with TAE followed by RFA in the same session, for a total of 36 treated lesions. Patients were extrapolated from a cohort of patients discussed within the weekly institutional tumor board. TAE was performed by using 100 μm microspheres; RFA was performed immediately after TAE by positioning the electrode needle via ultrasound and/or computed tomographic guidance. Local tumor responses and procedure-related complications were evaluated.
  
  
  RESULTS
  Completion of both procedures was obtained in all patients for all 36 lesions. Liver lesions had a maximum axial diameter ranging 16-59 mm. Postintervention unenhanced ablated areas ranged 28-104 mm in maximum axial diameter. Safety margins ranged 1-30.5 mm. Complete response, defined as complete devascularization at computed tomography, was obtained in all treated lesions for a maximum period of 12 months. Tumor relapse was observed in one patient at 12 months. Sixteen patients developed new liver lesions or progressive systemic disease during follow-up. Nine patients were still disease-free. Seven patients died as a result of systemic progressive disease. One major treatment-related complication was observed.
  
  
  CONCLUSIONS
  In patients with technically unresectable liver-only malignancies, single-session combined TAE-RFA is an effective and safe treatment.
authors.affiliation: Unit of Interventional Radiology, European Institute of Oncology, Via Ripamonti 435, 2041, Milan, Italy. guido.bonomo@ieo.it
authors.forename: Guido
authors.initials: G
authors.lastname: Bonomo
authors.forename: Paolo
authors.initials: P
authors.lastname: Della Vigna
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Monfardini
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Orgera
authors.forename: Antonio
authors.initials: A
authors.lastname: Chiappa
authors.forename: Paolo Pietro
authors.initials: PP
authors.lastname: Bianchi
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Zampino
authors.forename: Franco
authors.initials: F
authors.lastname: Orsi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D017115:Catheter Ablation / Q000379:methods*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome