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Intraoperative Radiofrequency Ablation for Hepatocellular Carcinoma: Long-Term Results in a Large Series

Annals of Surgical Oncology volume 15, Article number: 1862 (2008) Cite this article

Abstract

Background

Intraoperative radiofrequency (RF) ablation with or without surgical resection currently plays one of important roles in modern hepatocellular carcinoma (HCC) therapy. We evaluated long-term follow-up results including prognostic factors of intraoperative RF ablation for HCC that was difficult to treat percutaneously.

Methods

A total of 133 patients (male, 22 female, mean age 55.8 years) underwent intraoperative RF ablations for 200 HCCs (follow-up period 3.0–79.7 months, median 22.3 months). Hepatic resection was also performed in 29 patients. Reasons for the intraoperative procedure included no safe electrode path (n = 59), excessive tumor burden (n = 41), nonvisualization of the HCC on ultrasonography (n = 20), and risk of collateral thermal damage to adjacent organs (n = 13). We evaluated the technique effectiveness rate at 1 month computed tomography (CT), cumulative local tumor progression rate, cumulative disease-free and overall survival rates, and complications. We also sought significant prognostic factors for overall survival.

Results

The technique effectiveness at 1 month was 94.7% (126/133). The cumulative local tumor progression rates at 1 and 3 years were 4.9% and 8.8%, respectively. The cumulative disease-free and overall survival rates at 1, 3 and 5 years were 51.8%, 21.3%, and 16.0% and 92.3%, 72.6%, and 46.5%, respectively. Major complications occurred in nine patients (6.8%). Procedure-related mortality was 1.5% (2/133). The patients treated for recurrent HCC (P = 0.003) or with high serum alpha-fetoprotein levels (P = 0.009) had poor survival by multivariate analysis.

Conclusion

The results of this study showed that intraoperative radiofrequency ablation with or without hepatic resection is a safe and effective treatment for hepatocellular carcinoma in patients who are not candidates for the percutaneous approach.

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Affiliations

  1. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea

    Young-sun Kim MD, Hyunchul Rhim MD, Hyo K. Lim MD, Dongil Choi MD, Won Jae Lee MD & Tae Yeon Jeon MD

  2. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, 135-710, Korea

    Jae Won Joh MD & Sung Joo Kim MD

Authors
  1. Young-sun Kim MD
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  2. Hyunchul Rhim MD
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  3. Hyo K. Lim MD
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  4. Dongil Choi MD
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  5. Won Jae Lee MD
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  6. Tae Yeon Jeon MD
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  7. Jae Won Joh MD
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  8. Sung Joo Kim MD
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Correspondence to Hyunchul Rhim MD.

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Kim, Ys., Rhim, H., Lim, H.K. et al. Intraoperative Radiofrequency Ablation for Hepatocellular Carcinoma: Long-Term Results in a Large Series. Ann Surg Oncol 15, 1862 (2008). https://doi.org/10.1245/s10434-008-9941-y

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  • DOI: https://doi.org/10.1245/s10434-008-9941-y

Keywords

  • Hepatocellular carcinoma
  • Radiofrequency ablation
  • Hepatectomy
  • Complication