Advertisement

European Radiology

, 18:814 | Cite as

Radiofrequency ablation of high-grade dysplastic nodules in chronic liver disease: comparison with well-differentiated hepatocellular carcinoma based on long-term results

  • Seong Hyun Kim
  • Hyo K. LimEmail author
  • Min Ju Kim
  • Dongil Choi
  • Hyunchul Rhim
  • Cheol Keun Park
Hepatobiliary-Pancreas

Abstract

This retrospective study compared the long-term results of percutaneous radiofrequency (RF) ablation for high-grade dysplastic nodules (DNs) and well-differentiated hepatocellular carcinomas (HCCs). Between April 1999 and December 2006, 20 patients with 21 high-grade DNs (range, 1.2–3.0 cm; mean, 1.9 cm) (group 1) and 49 with a well-differentiated HCC (range, 1.0–5.0 cm; mean, 2.3 cm) (group 2) underwent RF ablation. The technique effectiveness, local tumor progression, cancer-free and cumulative survivals using the Kaplan-Meier method were compared. The technique effectiveness rates at 1 year after RF ablation were 100% (19/19) and 94.1% (32/34) in groups 1 and 2, respectively (P > 0.05). The local tumor progression rates in groups 1 and 2 were 0% and 20.6% (7/34), respectively (P = 0.041). The local tumor progression in group 2 was seen on follow-up computed tomography 4–58 months (mean, 17 months) after RF ablation. The 1-, 3-, and 5-year cancer-free survival rates in groups 1 and 2 were 95.0% and 76.9%, 56.2% and 44.6%, and 38.5% and 24.8%, respectively (P > 0.05). The 1-, 3-, and 5-year cumulative survival rates in groups 1 and 2 were 100% and 97.9%, 73.0% and 68.0%, and 63.8% and 51.1%, respectively (P > 0.05). Percutaneous RF ablation is effective for treating high-grade DNs and well-differentiated HCCs. The long-term results after RF ablation of high-grade DNs may be improved compared with those of well-differentiated HCCs.

Keywords

High-grade dysplastic nodule Well-differentiated hepatocellular carcinoma Radiofrequency ablation Survival 

References

  1. 1.
    Kobayashi M, Ikeda K, Hosaka T, Sezaki H, Someya T, Akuta N, Suzuki F, Suzuki Y, Saitoh S, Arase Y, Kumada H (2006) Dysplastic nodules frequently develop into hepatocellular carcinoma in patients with chronic viral hepatitis and cirrhosis. Cancer 106:636–647PubMedCrossRefGoogle Scholar
  2. 2.
    Hussain SM, Zondervan PE, IJzermans JN, Schalm SW, de Man RA, Krestin GP (2002) Benign versus malignant hepatic nodules: MR imaging findings with pathologic correlation. Radiographics 22:1023–1036PubMedGoogle Scholar
  3. 3.
    Lim JH, Kim MJ, Park CK, Kang SS, Lee WJ, Lim HK (2004) Dysplastic nodules in liver cirrhosis: detection with triple phase helical dynamic CT. Br J Radiol 77:911–916PubMedCrossRefGoogle Scholar
  4. 4.
    Borzio M, Fargion S, Borzio F, Fracanzani AL, Croce AM, Stroffolini T, Oldani S, Cotichini R, Roncalli M (2003) Impact of large regenerative, low grade and high grade dysplastic nodules in hepatocellular carcinoma development. J Hepatol 39:208–214PubMedCrossRefGoogle Scholar
  5. 5.
    Theise N (1995) Macroregenerative (Dysplastic) nodules and hepatocarcinogenesis: theoretical and clinical consideration. Semin Liver Dis 15:360–371PubMedCrossRefGoogle Scholar
  6. 6.
    Kaji K, Terada T, Nakanuma Y (1994) Frequent occurrence of hepatocellular carcinoma in cirrhotic livers after surgical resection of atypical adenomatous hyperplasia (borderline hepatocellular lesion): a follow-up study. Am J Gastroenterol 89:903–908PubMedGoogle Scholar
  7. 7.
    Rapaccini GL, Pompili M, Caturelli E, Caturelli E, Anti M, Aliotta A, Cedrone A, Amadei E, Grattagliano A, Squillante MM, Rabitti C, Gambassi G (1990) Focal ultrasound lesions in liver cirrhosis diagnosed as regenerating nodules by fine-needle biopsy: follow-up of 12 cases. Dig Dis Sci 35:422–427PubMedCrossRefGoogle Scholar
  8. 8.
    Okuda K (1986) What is the precancerous lesion for hepatocellular carcinoma in man? J Gastroenterol Hepatol 1:79CrossRefGoogle Scholar
  9. 9.
    Arakawa M, Kage M, Sugihara S, Nakashima T, Suenaga M, Okuda K (1986) Emergence of malignant lesions within an adenomatous hyperplastic nodule in a cirrhotic liver: observations in five cases. Gastroenterology 91:198–208PubMedGoogle Scholar
  10. 10.
    Liang P, Dong B, Yu X, Wang Y, Sheng L, Yu D, Xiao Q (2005) Sonography-guided percutaneous microwave ablation of high-grade dysplastic nodules in cirrhotic liver. AJR Am J Roentgenol 184:1657–1660PubMedGoogle Scholar
  11. 11.
    Lencioni R, Caramella D, Bartolozzi C, Mazzeo S, Di Coscio G (1994) Percutaneous ethanol injection therapy of adenomatous hyperplastic nodules in cirrhotic liver disease. Acta Radiol 35:138–142PubMedCrossRefGoogle Scholar
  12. 12.
    Lencioni R, Di Coscio G, Bagnolesi P, Cilotti A, Pinto F, Vignali C, Bartolozzi C (1992) Small nodules of adenomatous hyperplasia in the cirrhotic liver. Treatment with percutaneous alcoholization. Radiol Med (Torino) 84:74–78Google Scholar
  13. 13.
    Livraghi T, Sangalli G, Vettori C (1989) Adenomatous hyperplastic nodules in the cirrhotic liver: a therapeutic approach. Work in progress. Radiology 170:155–157PubMedGoogle Scholar
  14. 14.
    Lencioni R, Bartolozzi C, Caramella D, Di Coscio G (1993) Management of adenomatous hyperplastic nodules in the cirrhotic liver: US follow-up or percutaneous alcohol ablation. Abdom Imaging 18:50–55PubMedCrossRefGoogle Scholar
  15. 15.
    International Working Party (1995) Terminology of nodular hepatocellular lesions. Hepatology 22:983–993Google Scholar
  16. 16.
    Edmondson HA, Steiner PE (1954) Primary carcinoma of the liver: a study of 100 cases among 48,900 necropsies. Cancer 7:462–503PubMedCrossRefGoogle Scholar
  17. 17.
    Goldberg SN, Grassi CJ, Cardella JF, Charboneau JW, Dodd GD 3rd, Dupuy DE, Gervais D, Gillams AR, Kane RA, Lee FT Jr, Livraghi T, McGahan J, Phillips DA, Rhim H, Silverman SG, Society of Interventional Radiology Technology Assessment Committee (2005) Image-guided tumor ablation: standardization of terminology and reporting criteria. Radiology 235:728–739PubMedCrossRefGoogle Scholar
  18. 18.
    Sakamoto M, Hirohashi S, Shimosato Y (1991) Early stages of multistep hepatocarcinogenesis: adenomatous hyperplasia and early hepatocellular carcinoma. Hum Pathol 22:172–178PubMedCrossRefGoogle Scholar
  19. 19.
    Tsuda H, Hirohashi S, Shimosato Y, Terada M, Hasegawa H (1988) Clonal origin of atypical adenomatous hyperplasia of the liver and clonal identity with hepatocellular carcinoma. Gastroenterology 95:1664–1666PubMedGoogle Scholar
  20. 20.
    Takayama T, Makuuchi M, Hirohashi S, Sakamoto M, Okazaki N, Takayasu K, Kosuge T, Motoo Y, Yamazaki S, Hasegawa H (1990) Malignant transformation of adenomatous hyperplasia to hepatocellular carcinoma. Lancet 336:1150–1153PubMedCrossRefGoogle Scholar
  21. 21.
    Freeny PC, Baron RL, Teefey SA (1992) Hepatocellular carcinoma: reduced frequency of typical findings with dynamic contrast-enhanced CT in a non-Asian population. Radiology 182:143–148PubMedGoogle Scholar
  22. 22.
    Seki S, Sakaguchi H, Kitada T, Tamori A, Takeda T, Kawada N, Habu D, Nakatani K, Nishiguchi S, Shiomi S (2000) Outcomes of dysplastic nodules in human cirrhotic liver: a clinicopathological study. Clin Cancer Res 6:3469–3473PubMedGoogle Scholar
  23. 23.
    Arakawa M, Sugihara S, Kenmochi K, Kage M, Nakashima T, Nakayama T, Tashiro S, Hiraoka T, Suenaga M, Okuda K (1986) Small mass lesions in cirrhosis: transition from benign adenomatous hyperplasia to hepatocellular carcinoma? J Gastroenterol Hepatol 1:3–14CrossRefGoogle Scholar
  24. 24.
    Choi D, Lim HK, Rhim H, Kim YS, Lee WJ, Paik SW, Koh KC, Lee JH, Choi MS, Yoo BC (2007) Percutaneous radiofrequency ablation for early-stage hepatocellular carcinoma as a first-line treatment: long-term results and prognostic factors in a large single-institution series. Eur Radiol 17:684–692PubMedCrossRefGoogle Scholar
  25. 25.
    Kim SH, Lim HK, Choi D, Lee WJ, Kim SH, Kim MJ, Kim CK, Jeon YH, Lee JM, Rhim H (2006) Percutaneous radiofrequency ablation of hepatocellular carcinoma: effect of histologic grade on therapeutic results. AJR Am J Roentgenol 186:S327–S333PubMedCrossRefGoogle Scholar
  26. 26.
    Goldberg SN (2002) Comparison of techniques for image guided ablation of focal liver tumors. Radiology 223:304–307PubMedCrossRefGoogle Scholar
  27. 27.
    Nakazawa T, Kokubu S, Shibuya A, Ono K, Watanabe M, Hidaka H, Tsuchihashi T, Saigenji K (2007) Radiofrequency ablation of hepatocellular carcinoma: correlation between local tumor progression after ablation and ablative margin. AJR Am J Roentgenol 188:480–488PubMedCrossRefGoogle Scholar
  28. 28.
    Tsuda H, Oda T, Sakamoto M, Hirohashi S (1992) Different pattern of chromosomal allele loss in multiple hepatocellular carcinomas as evidence of their multifocal origin. Cancer Res 52:1504–1509PubMedGoogle Scholar
  29. 29.
    Sakamoto M, Hirohashi S (1998) Natural history and prognosis of adenomatous hyperplasia and early hepatocellular carcinoma: multi-institutional analysis of 53 nodules followed up for more than 6 months and 141 patients with single early hepatocellular carcinoma treated by surgical resection or percutaneous ethanol injection. Jpn J Clin Oncol 28:604–608PubMedCrossRefGoogle Scholar
  30. 30.
    Raut CP, Izzo F, Marra P, Ellis LM, Vauthey JN, Cremona F, Vallone P, Mastro A, Fornage BD, Curley SA (2005) Significant long-term survival after radiofrequency ablation of unresectable hepatocellular carcinoma in patients with cirrhosis. Ann Surg Oncol 12:616–628PubMedCrossRefGoogle Scholar
  31. 31.
    Tateishi R, Shiina S, Teratani T, Obi S, Sato S, Koike Y, Fujishima T, Yoshida H, Kawabe T, Omata M (2005) Percutaneous radiofrequency ablation for hepatocellular carcinoma: an analysis of 1000 cases. Cancer 103:1201–1209PubMedCrossRefGoogle Scholar
  32. 32.
    Lencioni R, Cioni D, Crocetti L, Franchini C, Pina CD, Lera J, Bartolozzi C (2005) Early-stage hepatocellular carcinoma in patients with cirrhosis: long-term results of percutaneous image-guided radiofrequency ablation. Radiology 234:961–967PubMedCrossRefGoogle Scholar

Copyright information

© European Society of Radiology 2007

Authors and Affiliations

  • Seong Hyun Kim
    • 1
  • Hyo K. Lim
    • 1
    Email author
  • Min Ju Kim
    • 1
  • Dongil Choi
    • 1
  • Hyunchul Rhim
    • 1
  • Cheol Keun Park
    • 2
  1. 1.Department of Radiology and Center for Imaging Science, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  2. 2.Department of Pathology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea

Personalised recommendations