Namık Kemal ALTINBAŞ, Cemil YAĞCI, Ayhan ALPAR, Cetin Murat ALTAY

Radiofrequency ablation of hepatocellular cancer: Complication and residual tumor rates

Aim: To investigate the feasibility, technical success and complication rates of RF ablation in hepatocellular carcinoma (HCC).Material and Methods: 34 patients (26 male, 8 female) with HCC who underwent percutaneous RF ablation were analyzed, retrospectively. In order to diagnose HCC, using criteria defined by American Association for the Study of Liver Diseases guidelines and the inclusion criteria were determined according to Barcelona criteria. Ultrasound (n=24) or CT (n=10) were used as guideline imaging method for ablation. All ablation procedures were performed with a monopolar ablation device. The successful procedure was defined as the tolerance of patient and completion of the RF ablation with normal vital sing. Technical success was defined as the lack of residual tumor on the follow-up imaging at one month. Residual tumor and complication rate were recorded in each patient.Results: The procedure was successfully performed in all patients (100%). There was a residual tumor in just one subcapsular localized lesion (2.9%). The technical success rate was 97.%. As a major complication in 2 patients (5.9%), pneumothorax was detected. There was no procedure-related mortality.Conclusions: RF ablation was a safe and an effective treatment for HCC, with high technical success rates and low complication rates.

PDF

___

Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin 2015;65:87-108.
Feng K, Ma KS. Value of radiofrequency ablation in the treatment of hepatocellular carcinoma. World J Gastroenterol 2014;20:5987-98.
Vogl TJ, Farshid P, Naguib NN, et al. Ablation therapy of hepatocellular carcinoma: a comparative study between radiofrequency and microwave ablation. Abdominal Imaging 2015;40:1829-37.
Rossi S, Di Stasi M, Buscarini E, et al. Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer. AJR Am J Roentgenol 1996;167:759-68.
Künzli BM, Abitabile P, Maurer CA. Radiofrequency ablation of liver tumors: Actual limitations and potential solutions in the future. World J Hepatol 2011;3:8-14.
Cucchetti A, Piscaglia F, Cescon M, et al. Cost-effectiveness of hepatic resection versus percutaneous radiofrequency ablation for early hepatocellular carcinoma. J Hepatol 2013;59:300-7.
Magnetta MJ, Xing M, Zhang D, et al. The Effect of Bridging Locoregional Therapy and Sociodemographics on Survival in Hepatocellular Carcinoma Patients Undergoing Orthotopic Liver Transplantation: A United Network for Organ Sharing Population Study. J Vasc Interv Radiol 2016;27:1822-8.
Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology 2011;53:1020-2.
Goldberg SN, Grassi CJ, Cardella JF, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria. J Vasc Interv Radiol 2009;20:S377-90.
Kim YS, Lim HK, Rhim H, et al. Ten-year outcomes of percutaneous radiofrequency ablation as first-line therapy of early hepatocellular carcinoma: analysis of prognostic factors. J hepatol 2013;58:89-97.
Seror O, N’Kontchou G, Van Nhieu JT, et al. Histopathologic comparison of monopolar versus no-touch multipolar radiofrequency ablation to treat hepatocellular carcinoma within Milan criteria. J vasc Interv Radiol. 2014;25:599-607.
Komorizono Y, Oketani M, Sako K, et al. Risk factors for local recurrence of small hepatocellular carcinoma tumors after a single session, single application of percutaneous radiofrequency ablation. Cancer 2003 97:1253-62.
Brieger J, Pereira PL, Trübenbach J, et al. In vivo efficiency of four commercial monopolar radiofrequency ablation systems: a comparative experimental study in pig liver. Invest Radiol 2003;38:609-16.
Pereira PL, Trü benbach J, Schenk M, et al. Radiofrequency ablation: in vivo comparison of four commercially available devices in pig livers. Radiology 2004;232:482-90.
Xu Q, Kobayashi S, Ye X, et al. Comparison of hepatic resection and radiofrequency ablation for small hepatocellular carcinoma: a meta-analysis of 16,103 patients. Sci Rep 2014;4:7252.
Shiina S, Tateishi R, Arano T, et al. Radiofrequency ablation for hepatocellular carcinoma: 10-year outcome and prognostic factors. The American Journal of Gastroenterology 2012;107:569-77.
Kang TW, Lim HK, Lee MW, et al. Long-term therapeutic outcomes of radiofrequency ablation for subcapsular versus nonsubcapsular hepatocellular carcinoma: a propensity score matched study. Radiology 2016;280:300-12.
Fonseca AZ. Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors. World J Hepatol 2014;6:107-13.
Takaki H, Yamakado K, Nakatsuka A, et al. Frequency of and risk factors for complications after liver radiofrequency ablation under CT fluoroscopic guidance in 1500 sessions: single-center experience. AJR Am J Roentgenol 2013; 200:658-64.
Livraghi T, Solbiati L, Meloni MF, et al. Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study. Radiol 2003;226:441-51.
Iguchi T, Inoue D, Yabushita K, et al. Effect of CT fluoroscopy-guided transpulmonary radiofrequency ablation of liver tumours on the lung. Br J Radiol 2012;85:e373-e7.
Minami Y, Kudo M, Kawasaki T, et al. Percutaneous ultrasound-guided radiofrequency ablation with artificial pleural effusion for hepatocellular carcinoma in the hepatic dome. Journal of Gastroenterology 2003;38:1066-70.
Rhim H, Lim HK. Radiofrequency ablation for hepatocellular carcinoma abutting the diaphragm: the value of artificial ascites. Abdominal imaging 2009;34:371-80.
Zhang Q, Li X, Pan J, et al. Transpulmonary computed tomography-guided radiofrequency ablation of liver neoplasms abutting the diaphragm with multiple bipolar electrodes. Indian J Cancer 2015;52:64-8.