Radiofrequency ablation of hepatocellular carcinoma: long-term experience with expandable needle electrodes.

OBJECTIVE

Our objective was to determine the efficacy of radiofrequency ablation, using expandable electrodes, in the treatment of patients with hepatocellular carcinoma (HCC).

SUBJECTS AND METHODS

In a 5-year period (1998-2003), 68 HCCs in 59 patients (age range, 47-88 years) were treated percutaneously with radiofrequency ablation using expandable needle electrodes. The mean lesion diameter was 3.1 cm (range, 1-12 cm). Fifty-one of 59 patients were in Child-Pugh class A, and eight were in class B. Follow-up was performed by helical CT at 1, 4, and 6 months and every 6 months after that. The mean follow-up was 24.1 months (range, 6-60 months). Survival and disease-free survival rates were evaluated separately by statistical analysis. Any complications were reported during follow-up.

RESULTS

Cumulative survival rates were 94.4%, 65%, and 43.1% at 1, 3, and 5 years, respectively. Median survival time was 23.6 months (range, 4-62 months). Maximum tumor diameter was associated with the probability of survival: 73% among patients with lesion diameters of 3 cm or less, 76.5% among patients with lesion diameters of 3-5 cm, and only 40% among patients with lesion diameters of more than 5 cm (p = 0.05, log-rank test; p = 0.07, Tarone-Ware test). In 34 (57.6%) of 59 patients during follow-up, new nodules noncontiguous with the treated nodule developed in the liver (tumor recurrences). Median disease-free survival rates were 32.1%, 28.1%, and 17.5% at 1, 2, and 3 years, respectively. One major complication occurred (hemoperitoneum that required transfusion).

CONCLUSION

Radiofrequency ablation with expandable electrodes is safe and effective in the treatment of HCC.