title: Safety assessment and therapeutic efficacy of percutaneous microwave ablation therapy combined with percutaneous ethanol injection for hepatocellular carcinoma adjacent to the gallbladder.
abstract: OBJECTIVE
  This study sought to evaluate the safety and efficacy of ultrasound-guided (US-guided) percutaneous microwave (MW) ablation combined with percutaneous ethanol injection (PEI) to treat liver tumours adjacent to the gallbladder.
  
  
  METHODS
  A total of 136 patients with hepatocellular carcinoma (HCC) adjacent to the gallbladder, who underwent ultra-sonographically-guided percutaneous MW ablation, which was combined with PEI in 132 patients, were retrospectively assessed. The patient population characteristics, tumour features, local tumour progression and treatment were compared and analysed. The safety and efficacy of the therapy were assessed by clinical data and imaging in follow-up examinations.
  
  
  RESULTS
  All patients were completely treated with two sessions; 120 patients underwent one session, 16 patients underwent two sessions. The primary technique was effective in 95.6% of the cases, according to the computed tomography (CT) or magnetic resonance imaging (MRI) in the one-month follow-up (132 of 138 sessions). PEI and other therapies were performed in the patients who had been incompletely treated (all six patients underwent PEI, and some underwent other therapies, including one transcatheter arterial chemoembolisation (TACE), one liver transplantation and two liver resections). There was a median follow-up period of 30.1 months and a range of 4 to 68 months. None of the patients had major complications. There were no treatment-related deaths. Twenty-six patients died of primary disease progression that was not directly attributable to MW ablation (19.1%, 26/136). Local tumour progression was noted in five patients (3.7%, 5/136), who had completely ablated tumours at follow-up. The patients with locally progressing tumours underwent additional therapy (three patients underwent PEI, one patient TACE, and one liver resection).
  
  
  CONCLUSIONS
  Ultrasound-guided percutaneous MW ablation, in combination with percutaneous ethanol injection and thermal monitoring, is a safe and effective treatment for HCC adjacent to the gallbladder.
authors.affiliation: Department of Interventional Ultrasound, Chinese PLA General Hospital , Beijing , China.
authors.forename: Hui
authors.initials: H
authors.lastname: Huang
authors.forename: Ping
authors.initials: P
authors.lastname: Liang
authors.forename: Xiao-ling
authors.initials: XL
authors.lastname: Yu
authors.forename: Zhi-gang
authors.initials: ZG
authors.lastname: Cheng
authors.forename: Zhi-yu
authors.initials: ZY
authors.lastname: Han
authors.forename: Jie
authors.initials: J
authors.lastname: Yu
authors.forename: Fang-yi
authors.initials: FY
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D017115:Catheter Ablation / Q000009:adverse effects; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D005704:Gallbladder; D006801:Humans; D007267:Injections; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008872:Microwaves; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000431:Ethanol
keywords: Ethanol injection; gallbladder; hepatocellular carcinoma; microwave ablation; thermal monitoring