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Incidence and clinical impact of bile ducts changes after multibipolar radiofrequency ablation for hepatocellular carcinoma

  • Interventional
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Abstract

Objectives

This study aimed to evaluate the incidence and clinical implications of bile duct changes following multibipolar radiofrequency ablation (mbpRFA) for hepatocellular carcinoma (HCC).

Materials and methods

Radiological, clinical, and biological data from consecutive cirrhotic patients who underwent first-line mbpRFA between 2007 and 2014 for uninodular HCC ≤ 5 cm were retrospectively collected. Follow-up imaging was reviewed to identify bile duct changes and factors associated with biliary changes were assessed using multivariable analysis. Baseline and 6-month liver function tests were compared in patients with and without bile duct changes. Complications, cirrhosis decompensation, and survival rates were compared in both groups.

Results

A total of 231 patients (mean age 68 years [39-85], 187 men) underwent 266 mbpRFA sessions for uninodular HCC (mean size 26 mm). Of these, 76 (33%) developed bile duct changes (upstream bile duct dilatations and/or bilomas) with a mean onset time of 3 months. Identified risk factors for these changes were the infiltrative aspect of the tumor (p = 0.035) and its location in segment VIII (p < 0.01). The average increase in bilirubin at 6 months was higher in the group with biliary changes (+2.9 vs. +0.4 µg/mL; p = 0.03). There were no significant differences in terms of complications, cirrhosis decompensation at 1 year (p = 0.95), local and distant tumor progression (p = 0.91 and 0.14 respectively), and overall survival (p = 0.4) between the two groups.

Conclusion

Bile duct changes are common after mbpRFA for HCC, especially in tumors with an infiltrative aspect or those located in segment VIII. These changes do not appear to negatively impact the course of cirrhosis at 1 year or overall survival.

Clinical relevance statement

Bile duct changes following mbpRFA for HCC are relatively common. Nevertheless, they do not raise clinical concerns in terms of complications, deterioration in liver function, or survival rates. Consequently, specific monitoring or interventions for these bile duct changes are not warranted.

Key Points

• Bile duct changes are frequently observed after multibipolar radiofrequency ablation for hepatocellular carcinoma, occurring in 33% of cases in our study.

• Patients with bile duct changes exhibited a higher increase in bilirubin levels at 6 months but no more cirrhosis decompensation or liver abscesses.

• Biliary changes following multibipolar radiofrequency ablation for hepatocellular carcinoma are not alarming and do not necessitate any specific monitoring or intervention.

Graphical abstract

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Abbreviations

ACLF:

Acute-on-chronic liver failure

DTP:

Distant tumor progression

HCC:

Hepatocellular carcinoma

LTP:

Local tumor progression

MbpRFA:

Multibipolar radiofrequency ablation

PT:

Prothrombin time

RFA:

Radiofrequency ablation

SIR:

Society of Interventional Radiology

γGT:

Gamma glutamyl transferase

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Acknowledgements

The final version of the text has been improved using ChatGPT.

Funding

The authors state that this work has not received any funding.

Author information

Author notes

  1. Eloi Varin, Paul Beunon, Olivier Seror, and Olivier Sutter equally contributed to this work.

Authors and Affiliations

  1. Interventional Radiology Unit, Hôpital Avicenne, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique Hôpitaux de Paris, Bobigny, France

    Eloi Varin, Paul Beunon, Arthur Petit, Lorenzo-Carlo Pescatori, Olivier Seror & Olivier Sutter

  2. Liver Unit, Hôpital Avicenne, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique Hôpitaux de Paris, Bobigny, France

    Gisèle N’Kontchou, Nathalie Ganne-Carrié & Jean-Charles Nault

  3. Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Sorbonne Paris Nord, Bobigny, France

    Lorenzo-Carlo Pescatori, Nathalie Ganne-Carrié, Jean-Charles Nault & Olivier Seror

  4. Centre de recherche des Cordeliers, Sorbonne Université, Inserm, Université Paris Cité, team « Functional Genomics of Solid Tumors », Equipe labellisée Ligue Nationale Contre le Cancer, Labex OncoImmunology, F-75006, Paris, France

    Nathalie Ganne-Carrié, Jean-Charles Nault & Olivier Seror

Authors
  1. Eloi Varin
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  9. Olivier Sutter
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Corresponding author

Correspondence to Olivier Sutter.

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The scientific guarantor of this publication is Olivier Sutter.

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The other authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (JCN) has significant statistical expertise.

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Written informed consent was waived by the Institutional Review Board.

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Institutional Review Board approval was obtained (CLEA-2023-n°346)

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Varin, E., Beunon, P., N’Kontchou, G. et al. Incidence and clinical impact of bile ducts changes after multibipolar radiofrequency ablation for hepatocellular carcinoma. Eur Radiol (2024). https://doi.org/10.1007/s00330-024-10617-7

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