Reiterative Radiofrequency Ablation in the Management of Pediatric Patients with Hepatoblastoma Metastases to the Lung, Liver, or Bone

Steven Yevich, Marco Calandri, Guillaume Gravel, Brice Fresneau, Laurence Brugières, Dominique Valteau-Couanet, Sophie Branchereau, Christophe Chardot, Isabelle Aerts, Thierry de Baere, Lambros Tselikas, Frederic Deschamps

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background and Purpose: Conventional treatments of systemic chemotherapy and surgical resection for recurrent or metastatic hepatoblastoma (HB) may be inhibitive for the pediatric patient and family who have already been through extensive therapies. This single-institution case series evaluates the safety and efficacy of percutaneous radiofrequency ablation (RFA) in the management of metastatic HB. Materials and Methods: Between March 2008 and February 2015, RFA was used as part of multidisciplinary management for HB recurrence or metastasis in 5 children (median 5.0 years old) in an attempt to provide locoregional control and preclude additional surgery. Combined local treatments of 38 metachronous metastases included surgical metastasectomy (14 lesions: 7 lung, 7 liver), percutaneous RFA (23 lesions: 21 lung, 1 liver, 1 bone), and stereotactic radiotherapy (1 liver lesion). Results: For lesions treated with RFA (median diameter 6 mm, range 3–15 mm), local control was achieved in 22/23 metastases (95.6%) with median follow-up of 30.1 months after RFA (range 18.9–65.7). Median hospitalization was 3 days (2–7), with major complications limited to 1 pneumothorax requiring temporary small-caliber chest tube. Four children remain in complete remission with median follow-up of 67 months (range 41.2–88.8) after primary tumor resection, with mean disease-free survival of 31.7 months after last local treatment. One child succumbed to rapidly progressive disease 12 months after RFA (23.9 months after primary tumor resection). Conclusion: RFA provides a safe and effective reiterative treatment option in the multidisciplinary management of children with metastatic HB.

Original languageEnglish (US)
Pages (from-to)41-47
Number of pages7
JournalCardiovascular and Interventional Radiology
Volume42
Issue number1
DOIs
StatePublished - Jan 1 2019

Keywords

  • Ablation
  • Hepatoblastoma
  • Metastasis
  • Pediatric
  • Radiofrequency

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Yevich, S., Calandri, M., Gravel, G., Fresneau, B., Brugières, L., Valteau-Couanet, D., Branchereau, S., Chardot, C., Aerts, I., de Baere, T., Tselikas, L., & Deschamps, F. (2019). Reiterative Radiofrequency Ablation in the Management of Pediatric Patients with Hepatoblastoma Metastases to the Lung, Liver, or Bone. Cardiovascular and Interventional Radiology, 42(1), 41-47. https://doi.org/10.1007/s00270-018-2097-7