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. 2016 Mar;90(3):147-56.
doi: 10.4174/astr.2016.90.3.147. Epub 2016 Feb 26.

Intraoperative radiofrequency ablation for hepatocellular carcinoma in 112 patients with cirrhosis: a surgeon's view

Jung Yeon Lee  1 , Young Hoon Kim  1 , Young Hoon Roh  1 , Kyung Bin Roh  1 , Kwan Woo Kim  1 , Sung Hwa Kang  1 , Yang Hyun Baek  2 , Sung Wook Lee  2 , Sang Young Han  2 , Hee Jin Kwon  3 , Jin Han Cho  3
Affiliations

Intraoperative radiofrequency ablation for hepatocellular carcinoma in 112 patients with cirrhosis: a surgeon's view

Jung Yeon Lee et al. Ann Surg Treat Res. 2016 Mar.

Abstract

Purpose: This retrospective study was an investigation of overall survival (OS), disease-free survival (DFS) and prognostic factors affecting OS and DFS in cirrhotic patients who received intraoperative radiofrequency ablation (IORFA).

Methods: Between April 2009 and November 2013, 112 patients (94 men, 84%; 18 women, 16%) underwent IORFA for 185 cases of hepatocellular carcinomas (HCC). Repeat IORFA was done in 9 patients during the same period (total of 121 treatments).

Results: All patients were followed-up for at least 12 months (mean follow-up, 32 months). Surgical resection combined with IORFA was performed in 20 patients. The technical effectiveness at 1 week was 91.78% (111 of 121). Readmission was 9.1% (11 of 121) and the most common cause was ventral hernia. Procedure-related mortality was 2.7% (3 of 112) and continued fatal biliary leakage was 1.8% (2 of 112). Local recurrence developed in 10 patients (8.9%). Most recurrence was intrahepatic. Cumulative survival was assessed in 33 patients who received IORFA as primary treatment (naive patients) and 79 non-naive patients. The cumulative DFS and OS rate at l and 3 years was 54% and 24%, and 87% and 66%, respectively. Moderate ascites (P = 0.001), tumor located segment I (P = 0.001), portal vein thrombosis (P = 0.001) had poor survival were significant factors by multivariate analysis.

Conclusion: IORFA alone or in combination with surgical resection extends the spectrum of liver surgery. A fundamental understanding of RFA, additional comorbidities, and postablation complication are necessary to maximize the safety and efficacy of IORFA for treating HCC with cirrhosis.

Keywords: Hepatocellular carcinoma; Intraoperative; Radiofrequency ablation.

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Conflict of interest statement

CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. The cumulative rates for local tumor progression (A), intrahepatic distant recurrence (B) of the 112 patients who underwent intraoperative radiofrequency ablation. RFA, radiofrequency ablation.
Fig. 2
Fig. 2. The cumulative rates for disease-free survival (A) overall survival (B) of the 112 patients who underwent intraoperative radiofrequency ablation. RFA, radiofrequency ablation.
Fig. 3
Fig. 3. Patients without portal vein thrombosis (PVT) had a statistically significant longer overall survival compared to patients with PVT (P = 0.004). RFA, radiofrequency ablation.
See this image and copyright information in PMC

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