Histopathologic and immunohistochemical features of tissue adherent to multitined electrodes after RF ablation of liver malignancies can help predict local tumor progression: Initial results Journal Article


Authors: Sofocleous, C. T.; Nascimento, R. G.; Petrovic, L. M.; Klimstra, D. S.; Gonen, M.; Brown, K. T.; Brody, L. A.; Covey, A. M.; Thornton, R. H.; Fong, Y.; Solomon, S. B.; Schwartz, L. H.; DeMatteo, R. P.; Getrajdman, G. I.
Article Title: Histopathologic and immunohistochemical features of tissue adherent to multitined electrodes after RF ablation of liver malignancies can help predict local tumor progression: Initial results
Abstract: Purpose: To determine whether histopathologic and immunohistochemical features of tissue adherent to electrodes after radiofrequency (RF) ablation of liver malignancies can help predict local tumor progression (LTP). Materials and Methods: Institutional review board waiver and informed consent were obtained. Histologic and immunohistochemical examinations of tissue adherent to electrodes after RF ablation of liver malignancies were performed, with application of proliferation (Ki-67) and apoptosis (caspase-3) markers. Clinical and technical information were prospectively collected for an HIPAA-registered database. Medical records and imaging were reviewed to determine LTP for treated tumors smaller than 5 cm in diameter. LTP-free and survival rates were assessed with Kaplan-Meier method; differences between groups assessed with permutation log-rank test. Multivariate analysis assessed with Cox regression for factors related to LTP. Results: Sixty-eight malignant tumors treated with RF ablation were identified. Fifty-five tissue specimens were classified as coagulation necrosis (CN), thermal artifact only, or tumor cells positive for caspase-3/negative for Ki-67; and 13 as viable tumor cells (Ki-67 positive). Mean tumor size was larger in viable (3.4 cm) than in CN (2.5 cm) group before treatment (P = .01). For viable and CN groups, LTP occurred in 12 (92%) of 13 and 16 (29%) of 55 specimens, respectively; 1-year LTP-free rates were 0% and 74%, respectively (P < .001). Multivariate analysis confirmed that viable cells comprise independent risk factor for LTP (P < .001). The odds of LTP is six times greater in viable group compared with CN group for tumors 3-5 cm (hazard ratio: 5.9, 95% confidence interval: 2.4, 14.5) and 10 times greater for tumors smaller than 3 cm (hazard ratio: 10.1, 95% confidence interval: 1.7, 57.5). Median survival was 32.7 months. Conclusion: Evidence of Ki-67-positive tumor cells on the electrode after hepatic RF ablation is an independent predictor of LTP. © RSNA, 2008.
Keywords: immunohistochemistry; cancer survival; human tissue; major clinical study; clinical feature; disease course; histopathology; mortality; cancer growth; liver neoplasms; cancer radiotherapy; prospective study; prospective studies; ki 67 antigen; cell proliferation; ki-67 antigen; cell division; apoptosis; tumor volume; caspase 3; pathology; data base; prediction; risk factor; instrumentation; disease progression; liver tumor; medical record; radiofrequency ablation; catheter ablation; electrode; microphotography; cefazolin; electrodes
Journal Title: Radiology
Volume: 249
Issue: 1
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2008-10-01
Start Page: 364
End Page: 374
Language: English
DOI: 10.1148/radiol.2491071752
PUBMED: 18796687
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 8" - "Export Date: 17 November 2011" - "CODEN: RADLA" - "Source: Scopus"
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MSK Authors
  1. Ronald P DeMatteo
    627 DeMatteo
  2. Mithat Gonen
    782 Gonen
  3. Lawrence H Schwartz
    282 Schwartz
  4. Anne Covey
    134 Covey
  5. David S Klimstra
    916 Klimstra
  6. Yuman Fong
    772 Fong
  7. Lynn Brody
    100 Brody
  8. Karen T Brown
    171 Brown
  9. Stephen Solomon
    306 Solomon