European Radiology

, Volume 29, Issue 5, pp 2706–2715 | Cite as

Radiofrequency ablation for subcardiac hepatocellular carcinoma: therapeutic outcomes and risk factors for technical failure

  • Dong Ik Cha
  • Tae Wook KangEmail author
  • Kyoung Doo Song
  • Min Woo Lee
  • Hyunchul Rhim
  • Hyo Keun Lim
  • Dong Hyun Sinn
  • Kyunga Kim



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.

Key Points

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).


Liver Hepatocellular carcinoma Ablation techniques Heart Treatment outcome 



Confidence interval


Computed tomography


Hepatocellular carcinoma


Local tumor progression


Odds ratio




Receiver operating characteristic


Transarterial chemoembolization





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.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.


• Retrospective

• Case-control study

• Performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Dong Ik Cha
    • 1
  • Tae Wook Kang
    • 1
    Email author
  • Kyoung Doo Song
    • 1
  • Min Woo Lee
    • 1
  • Hyunchul Rhim
    • 1
  • Hyo Keun Lim
    • 1
    • 2
  • Dong Hyun Sinn
    • 3
  • Kyunga Kim
    • 4
  1. 1.Department of Radiology and Center for Imaging Science, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  2. 2.Department of Health Sciences and Technology, SAIHSTSungkyunkwan University School of MedicineSeoulRepublic of Korea
  3. 3.Department of Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  4. 4.Statistics and Data Center, Research Institute for Future MedicineSamsung Medical CenterSeoulRepublic of Korea

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