Radiofrequency ablation for subcardiac hepatocellular carcinoma: therapeutic outcomes and risk factors for technical failure
- 117 Downloads
To compare the therapeutic outcomes and safety of radiofrequency (RF) ablation for subcardiac and non-subcardiac hepatocellular carcinoma (HCC) and to evaluate the risk factors for technical failure of the procedure.
This retrospective study was approved by the institutional review board. Between September 2002 and May 2016, 73 patients with subcardiac HCC and the same number of patients with non-subcardiac HCC matched by tumor size were included. Subcardiac HCC was defined as an index tumor that was located ≤ 1 cm from the pericardium in axial or coronal images. Cumulative local tumor progression (LTP) was compared between the two groups using the log-rank test. Prognostic factors for technical failure were assessed using multivariable logistic analysis.
Technical success rates between both groups were not significantly different (91.8% in the subcardiac HCC group vs. 95.9% in the non-subcardiac HCC group; p = 0.494). The cumulative LTP rates were 15.4% and 19.1% at 3 and 5 years, respectively, in the subcardiac HCC group, and 10.7% and 15.5% in the non-subcardiac HCC group, without significant difference (p = 0.862). The distance between the index tumor and pericardium (odds ratio [OR], 0.14; p = 0.023) and tumor in segment IV (reference, left lateral sector; OR, 36.53; p = 0.029) were significant factors for technical failure in patients with subcardiac HCC.
RF ablation was an effective treatment for subcardiac HCC. However, tumor location should be considered in the planning of treatment to avoid technical failure.
• RF ablation for subcardiac HCC is technically feasible without major complications.
• RF ablation was an effective treatment for subcardiac HCC in terms of LTP.
• Risk factors for technical failure were distance of the index tumor from the heart (cutoff value of 0.5 cm) and the location of the tumor (segment IV).
KeywordsLiver Hepatocellular carcinoma Ablation techniques Heart Treatment outcome
Local tumor progression
Receiver operating characteristic
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Won Jae Lee.
Conflict of interest
The authors declare that they have no conflict of interest.
Statistics and biometry
One (Kyunga Kim) of the authors has significant statistical expertise.
Written informed consent was waived by the Institutional Review Board.
Institutional Review Board approval was obtained.
• Case-control study
• Performed at one institution
- 4.Kim YS, Lee WJ, Rhim H, Lim HK, Choi D, Lee JY (2010) The minimal ablative margin of radiofrequency ablation of hepatocellular carcinoma (> 2 and < 5 cm) needed to prevent local tumor progression: 3D quantitative assessment using CT image fusion. AJR Am J Roentgenol 195:758–765CrossRefGoogle Scholar
- 16.Lee S, Kang TW, Cha DI et al (2018) Radiofrequency ablation vs. surgery for perivascular hepatocellular carcinoma: propensity score analyses of long-term outcomes. J Hepatol 69:70–78Google Scholar
- 17.Kang TW, Lim HK, Lee MW, Kim YS, Choi D, Rhim H (2013) First-line radiofrequency ablation with or without artificial ascites for hepatocellular carcinomas in a subcapsular location: local control rate and risk of peritoneal seeding at long-term follow-up. Clin Radiol 68:e641–e651CrossRefGoogle Scholar