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dc.contributor.advisorPérez Hidalgo, Juan Manuel 
dc.contributor.advisorCárdenas-Roldán, Jorge 
dc.creatorAldana Silva, Carolina 
dc.creatorPiñeros Nieto, Diego Alejandro 
dc.date.accessioned2020-08-10T00:03:07Z
dc.date.available2020-08-10T00:03:07Z
dc.date.created2020-07-27
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/26518
dc.descriptionIntroducción: El carcinoma hepatocelular (CHC) tiene alta prevalencia y tasa de mortalidad a nivel mundial. El manejo de CHC pequeños con técnicas locorregionales guiadas por imágenes en pacientes candidatos a trasplante hepático, funciona de manera efectiva en la disminución del tamaño de las lesiones, con bajas tasas de complicaciones. Objetivo: Describir la experiencia en ablación por radiofrecuencia (ARF) y microondas (AMO) de lesiones focales hepáticas (LFH) probable o definitivamente sugestivas de CHC en una institución con centro de trasplante de cuarto nivel. Materiales y métodos: De 2013 a 2019, 97 pacientes con CHC se manejaron con ARF/AMO en la Fundación Cardioinfantil, para un total de 158 lesiones. Se revisaron de manera retrospectiva los datos clínicos, número y tamaño de las lesiones, respuesta y complicaciones. Se realizó un análisis univariado y bivariado en los programas SPSS y R. Resultados: 68 pacientes cumplieron los criterios de inclusión, 64,7% eran hombres, con edad media de 68,2 años. La causa de cirrosis (58,8% Child A) más prevalente fue la alcohólica (23,5%). Todas las lesiones clasificadas LIRADS (LR) 4 (probablemente CHC) o LR 5 (definitivamente CHC), con tamaño promedio de 2,4 cm. Se obtuvo respuesta completa en el 76,5% de las lesiones manejadas. Conclusión: La ablación es una técnica de tratamiento locorregional que produce calor y generar destrucción tumoral mediante necrosis por licuefacción. Esta es una técnica segura, con baja tasa de complicaciones y funciona como terapia puente en pacientes enlistados a trasplante.
dc.description.abstractIntroduction: Hepatocellular carcinoma (HCC) has high worldwide prevalence and mortality rate. Treatment of small HCC with image-guided locoregional techniques in patients candidates for liver transplantation, works effectively in decreasing lesions size, with low complication rates. Objective: To describe the experience in radiofrequency ablation (RFA) and microwave ablation (MWA) of hepatic focal lesions probably or definitely HCC in the transplant center of a fourth level hospital. Materials and methods: From 2013 to 2019, 97 patients were treated with RFA/MWA at Fundación Cardioinfantil, for a total of 158 ablation procedures. Clinical data, number and size of lesions, response and complications were retrospectively reviewed. Univariate and bivariate analysis was performed using SPSS and R. Results: 68 patients were analyzed, 64,7% were men, with mean age of 68,2 years. Alcohol (23,5%) was the most related cause of cirrhosis (58,8% Child A). Most lesions LIRADS (LR) 4 (probably HCC) or LR 5 (definitely HCC), had an average size of 2,4 cm. Complete response was observed in 76,5% lesions. Conclusion: Ablation is a locoregional treatment technique that produce heat and inducing tumor destruction by liquefaction necrosis. This is a safe technique, with a low complications rate and works as a bridge therapy in patients enrolled for transplant.
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dc.rightsAtribución-NoComercial-SinDerivadas 2.5 Colombia
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
dc.sourcereponame:Repositorio Institucional EdocUR
dc.sourceinstname:Universidad del Rosario
dc.subjectCarcinoma hepatocelular
dc.subjectTécnicas de ablación
dc.subjectImagen por resonancia magnética
dc.subject.ddcGinecología & otras especialidades médicas 
dc.subject.ddcFarmacología & terapéutica 
dc.titleAblación percutánea por radiofrecuencia y microondas de lesiones focales hepáticas, experiencia en un hospital de alta complejidad.
dc.typemasterThesis
dc.publisherUniversidad del Rosario
dc.creator.degreeEspecialista en Radiología
dc.publisher.programEspecialización en Radiología
dc.publisher.departmentFacultad de Medicina
dc.title.alternativePercutaneous radiofrequency and microwave ablation of focal hepatic lesions, experience in a high complexity hospital.
dc.subject.keywordHepatocellular carcinoma
dc.subject.keywordAblation techniques
dc.subject.keywordMagnetic resonance imaging
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.type.spaTrabajo de grado
dc.rights.accesoAbierto (Texto Completo)
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.source.bibliographicCitationOrganization WH. International Agency for Research on Cancer.
dc.source.bibliographicCitationAmerican Cancer Society.
dc.source.bibliographicCitationElsayes KM, Hooker JC, Agrons MM, Kielar AZ, Tang A, Fowler KJ, et al. 2017 Version of LI-RADS for CT and MR Imaging: An Update. RadioGraphics [Internet]. 2017 Nov 13 [cited 2020 Jun 1];37(7):1994–2017. Available from: http://pubs.rsna.org/doi/10.1148/rg.2017170098
dc.source.bibliographicCitationMC N, I S, A C, D U, WA R, F C-M, et al. Hepatitis B and Hepatitis C Infection Biomarkers and TP53 Mutations in Hepatocellular Carcinomas From Colombia. Hepat Res Treat [Internet]. 2011 [cited 2020 Jun 11];2011. Available from: https://pubmed.ncbi.nlm.nih.gov/22114738/
dc.source.bibliographicCitationEl-Serag HB, Rudolph KL. Hepatocellular Carcinoma: Epidemiology and Molecular Carcinogenesis. Gastroenterology. 2007;132(7):2557–76.
dc.source.bibliographicCitationFeng K, Yan J, Li X, Xia F, Ma K, Wang S, et al. A randomized controlled trial of radiofrequency ablation and surgical resection in the treatment of small hepatocellular carcinoma. J Hepatol [Internet]. 2012;57(4):794–802. Available from: http://dx.doi.org/10.1016/j.jhep.2012.05.007
dc.source.bibliographicCitationLivraghi T, Meloni F, Di Stasi M, Rolle E, Solbiati L, Tinelli C, et al. Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: Is resection still the treatment of choice? Hepatology [Internet]. 2008 Jan [cited 2020 May 30];47(1):82–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18008357
dc.source.bibliographicCitationMcDermott S, Gervais DA. Radiofrequency ablation of liver tumors. Semin Intervent Radiol. 2013;30(1):49–55.
dc.source.bibliographicCitationZiemlewicz TJ, Wells SA, Lubner MG, Brace CL, Lee FT, Hinshaw JL. Hepatic Tumor Ablation. Surg Clin North Am. 2016;96(2):315–39.
dc.source.bibliographicCitationLau WY, Lai ECH. The current role of radiofrequency ablation in the management of hepatocellular carcinoma: a systematic review. Ann Surg [Internet]. 2009;249(1):20–5. Available from: papers3://publication/doi/10.1097/SLA.0b013e31818eec29
dc.source.bibliographicCitationLuming Chen JS, Yang X. Radiofrequency ablation-combined multimodel therapies for hepatocellular carcinoma: Current status. Cancer Lett. 2016;33(4):78–84.
dc.source.bibliographicCitationHALSTED WS. The Results of Operations for the Cure of Cancer of the Breast Performed At the Johns Hopkins Hospital From June, 1889, To January, 1894. Ann Surg. 1894;20:497–555.
dc.source.bibliographicCitationRossi S, Fornari F, Buscarini L. Percutaneous ultrasound-guided radiofrequency electrocautery for the treatment of small hepatocellular carcinoma. J Interv Radiol. 1993;8(3):97–103.
dc.source.bibliographicCitationKoda M, Murawaki Y, Hirooka Y, Kitamoto M, Ono M, Sakaeda H, et al. Complications of radiofrequency ablation for hepatocellular carcinoma in a multicenter study: An analysis of 16346 treated nodules in 13283 patients. Hepatol Res. 2012;42(11):1058–64.
dc.source.bibliographicCitationA F, R V, C A, L B, M S, JR A, et al. Diagnosis of Hepatic Nodules 20 Mm or Smaller in Cirrhosis: Prospective Validation of the Noninvasive Diagnostic Criteria for Hepatocellular Carcinoma. Hepatology [Internet]. 2008 [cited 2020 Jun 12];47(1). Available from: https://pubmed.ncbi.nlm.nih.gov/18069697/
dc.source.bibliographicCitationK K, TK K, HJ J, MA H, L K, M G, et al. Optimization of Imaging Diagnosis of 1-2 Cm Hepatocellular Carcinoma: An Analysis of Diagnostic Performance and Resource Utilization. J Hepatol [Internet]. 2011 [cited 2020 Jun 12];54(4). Available from: https://pubmed.ncbi.nlm.nih.gov/21156219/
dc.source.bibliographicCitationBashir MR, Do Memorial RK, Kettering S, Center C, Fowler KJ, San UC, et al. LI-RADS ® v2018 CT/MRI Manual The LI-RADS ® v2018 Manual Writing Group Members Writing Group Members-in-Training [Internet]. [cited 2020 Jun 12]. Available from: https://www.acr.org/-/media/ACR/Files/Clinical-Resources/LIRADS/LI-RADS-2018-Manual-5Dec18.pdf?la=en
dc.source.bibliographicCitationRonot M, Vilgrain V. Hepatocellular carcinoma: Diagnostic criteria by imaging techniques. Vol. 28, Best Practice and Research: Clinical Gastroenterology. 2014. p. 795–812.
dc.source.bibliographicCitationR L, JM L. Modified RECIST (mRECIST) Assessment for Hepatocellular Carcinoma. Semin Liver Dis [Internet]. 2010 [cited 2020 Jun 12];30(1). Available from: https://pubmed.ncbi.nlm.nih.gov/20175033/
dc.source.bibliographicCitationKielar A, Fowler KJ, Lewis S, Yaghmai V, Miller FH, Yarmohammadi H, et al. Locoregional Therapies for Hepatocellular Carcinoma and the New LI-RADS Treatment Response Algorithm. Abdom Radiol (New York) [Internet]. 2018 [cited 2020 Jun 12];43(1):218. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771991/
dc.source.bibliographicCitationZheng S-G, Xu H-X, Liu L-N. Management of hepatocellular carcinoma: The role of contrast-enhanced ultrasound. World J Radiol. 2014;6(1):7–14.
dc.source.bibliographicCitationShiina S, Tateishi R, Arano T, Uchino K, Enooku K, Nakagawa H, et al. Radiofrequency ablation for hepatocellular carcinoma: 10-year outcome and prognostic factors. Am J Gastroenterol. 2012;107(4):569–77; quiz 578.
dc.source.bibliographicCitationBouda D, Lagadec M, Alba CG, Barrau V, Burgio MD, Moussa N, et al. Imaging review of hepatocellular carcinoma after thermal ablation: The good, the bad, and the ugly. J Magn Reson Imaging. 2016;44(5):1070–90.
dc.source.bibliographicCitationKoda M, Tokunaga S, Miyoshi K, Kishina M, Fujise Y, Kato J, et al. Assessment of ablative margin by unenhanced magnetic resonance imaging after radiofrequency ablation for hepatocellular carcinoma. Eur J Radiol. 2012;81(10):2730–6.
dc.source.bibliographicCitationForner A, Reig M, Bruix J. Hepatocellular carcinoma. Lancet [Internet]. 2018 Mar 31 [cited 2020 Jun 11];391(10127):1301–14. Available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30010-2/fulltext
dc.source.bibliographicCitationRuzzenente A, De Angelis M, Conci S, Campagnaro T, Isa G, Bagante F, et al. The albumin-bilirubin score stratifies the outcomes of Child-Pugh class A patients after resection of hepatocellular carcinoma. Transl Cancer Res [Internet]. 2018 [cited 2020 Jun 12];8(3):S233–44. Available from: http://tcr.amegroups.com/article/view/26077
dc.source.bibliographicCitationIS O, DH S, TW K, MW L, W K, GY G, et al. Liver Function Assessment Using Albumin-Bilirubin Grade for Patients With Very Early-Stage Hepatocellular Carcinoma Treated With Radiofrequency Ablation. Dig Dis Sci [Internet]. 2017 [cited 2020 Jun 12];62(11). Available from: https://pubmed.ncbi.nlm.nih.gov/28983724/
dc.source.bibliographicCitationChen P-C, Chiu N-C, Su C-W, Huang Y-H, Hou M-C, Lin H-C, et al. Albumin-bilirubin grade may determine the outcomes of patients with very early stage hepatocellular carcinoma after radiofrequency ablation therapy. www.ejcma.org J Chin Med Assoc [Internet]. 2019 [cited 2020 Jun 12]; Available from: www.ejcma.org
dc.source.bibliographicCitationNi J-Y, An C, Zhang T-Q, Huang Z-M, Jiang X-Y, Huang J-H. Predictive value of the albumin-bilirubin grade on long-term outcomes of CT-guided percutaneous microwave ablation in intrahepatic cholangiocarcinoma. Int J Hyperth [Internet]. 2019 Jan 1 [cited 2020 Jun 12];36(1):327–35. Available from: https://www.tandfonline.com/doi/full/10.1080/02656736.2019.1567834
dc.source.bibliographicCitationHuang J, Yan L, Cheng Z, Wu H, Du L, Wang J, et al. A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria. Ann Surg. 2010;252(6):903–12.
dc.source.bibliographicCitationQi X, Tang Y, An D, Bai M, Shi X, Wang J, et al. Radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma: a meta-analysis of randomized controlled trials. J Clin Gastroenterol. 2014;48(5):450–7.
dc.source.bibliographicCitationChok KS, Ng KK, Poon RTP, Lam CM, Yuen J, Tso WK, et al. Comparable survival in patients with unresectable hepatocellular carcinoma treated by radiofrequency ablation or transarterial chemoembolization. Arch Surg. 2006;141(12):1231–6.
dc.source.bibliographicCitationNouso K, Kariyama K, Nakamura S, Oonishi A, Wakuta A, Oyama A, et al. Application of Radiofrequency Ablation for the Treatment of Intermediate-Stage Hepatocellular Carcinoma. J Gastroenterol Hepatol [Internet]. 2016;(January 2001):695–700. Available from: http://doi.wiley.com/10.1111/jgh.13586
dc.source.bibliographicCitationMurakami T, Ishimaru H, Sakamoto I, Uetani M, Matsuoka Y, Daikoku M, et al. Percutaneous radiofrequency ablation and transcatheter arterial chemoembolization for hypervascular hepatocellular carcinoma: Rate and risk factors for local recurrence. Cardiovasc Intervent Radiol. 2007;30(4):696–704.
dc.source.bibliographicCitationV M, E R, R D, S A, A P, F B, et al. Liver Transplantation for the Treatment of Small Hepatocellular Carcinomas in Patients With Cirrhosis. N Engl J Med [Internet]. 1996 [cited 2020 Jun 11];334(11). Available from: https://pubmed.ncbi.nlm.nih.gov/8594428/
dc.source.bibliographicCitationKim JH, Won HJ, Shin YM, Kim K-A, Kim PN. Radiofrequency ablation for the treatment of primary intrahepatic cholangiocarcinoma. AJR Am J Roentgenol. 2011;196(2):W205–9.
dc.source.bibliographicCitationOshowo A, Gillams A, Harrison E, Lees WR, Taylor I. Comparison of resection and radiofrequency ablation for treatment of solitary colorectal liver metastases. Br J Surg. 2003;90(10):1240–3.
dc.source.bibliographicCitationNieto IS de, Santaolaya M. Ablación por radiofrecuencia de los tumores hepáticos primarios y secundarios. An médicos. 2013;58(3):163–8.
dc.source.bibliographicCitationPugh RNH, Murray???Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973;60(8):646–9.
dc.source.bibliographicCitationJM L, R L. mRECIST for HCC: Performance and Novel Refinements. J Hepatol [Internet]. 2020 [cited 2020 Jun 12];72(2). Available from: https://pubmed.ncbi.nlm.nih.gov/31954493/
dc.source.bibliographicCitationIBM. IBM SPSS Statistics for Macintosh. Armonk, NY: IBM Corp: IBM Corp; 2013.
dc.source.bibliographicCitationDing J, Jing X, Wang Y, Wang F, Wang Y, Du Z. Thermal ablation for hepatocellular carcinoma: a large-scale analysis of long-term outcome and prognostic factors. Clin Radiol. 2016;71(12):1270–6.
dc.source.bibliographicCitationZheng RN, You ZJ, Lin SH, Jia J, Cai YM, Liu C, et al. Efficacy of percutaneous radiofrequency ablation for the treatment of hepatocellular carcinoma. Genet Mol Res. 2015;14(4):17982–94.
dc.source.bibliographicCitationDJ P, R S, E A, C Y, T A, K K, et al. The ALBI Grade Provides Objective Hepatic Reserve Estimation Across Each BCLC Stage of Hepatocellular Carcinoma. J Hepatol [Internet]. 2017 [cited 2020 Jun 13];66(2). Available from: https://pubmed.ncbi.nlm.nih.gov/27677714/?dopt=Abstract
dc.source.bibliographicCitationHiraoka A, Kumada T, Kudo M, Hirooka M, Tsuji K, Itobayashi E, et al. Albumin-Bilirubin (ALBI) Grade as Part of the Evidence-Based Clinical Practice Guideline for HCC of the Japan Society of Hepatology: A Comparison with the Liver Damage and Child-Pugh Classifications. Liver Cancer [Internet]. 2017 [cited 2020 Jun 13];6(3):204. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5473065/
dc.source.bibliographicCitationPompili M, Mirante VG, Rondinara G, Fassati LR, Piscaglia F, Agnes S, et al. Percutaneous ablation procedures in cirrhotic patients with hepatocellular carcinoma submitted to liver transplantation: Assessment of efficacy at explant analysis and of safety for tumor recurrence. Liver Transplant [Internet]. 2005 Sep 1 [cited 2020 Jun 13];11(9):1117–26. Available from: http://doi.wiley.com/10.1002/lt.20469
dc.source.bibliographicCitationGlassberg MB, Ghosh S, Clymer JW, Qadeer RA, Ferko NC, Sadeghirad B, et al. Microwave ablation compared with radiofrequency ablation for treatment of hepatocellular carcinoma and liver metastases: a systematic review and meta-analysis. Onco Targets Ther [Internet]. 2019 [cited 2020 May 26];12:6407–38. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31496742
dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.
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