Histopathology of the Tissue Adhering to the Multiple Tine Expandable Electrodes Used for Radiofrequency Ablation of Hepatocellular Carcinoma Predicts Local Recurrence

Abstract

Objective To assess the ability to predict the local recurrence of hepatocellular carcinoma by analyzing tissues adhering to the radiofrequency ablation probe after complete ablation. Methods From May 2002 to March 2011, tissue specimens adhering to the radiofrequency ablation probe from 284 radiofrequency ablation sessions performed for hepatocellular carcinomas ! 3 cm in size were analyzed. The specimens were classified as either viable tumor tissue or complete necrosis, and the local recurrence rates were calculated using the Kaplan-Meier method.Results From the tumors ! 3 cm in size, viable tissue was present in 6 (2.1%) of 284 specimens, and the local recurrence rates after 1 and 2 years of follow-up were 6.7% and 11.2%, respectively. Local recurrence developed significantly earlier in the viable tissue group. The recurrence rate was not significantly different based on whether transcatheter arterial chemoembolization was performed. Conclusion The histopathology of the tissue adhering to the radiofrequency ablation probes used for hepatocellular carcinoma treatment can predict local recurrence. Additional aggressive treatment for patients with viable tissue can therefore improve the overall survival.

Clinicopathology of recurrent hepatocellular carcinomas after radiofrequency ablation treated with salvage surgery

“…Obviously, poorly differentiated HCC grow more rapidly. Ki‐67 antigen is known to be preferentially expressed during all active phases of the cell cycle and the Ki‐67 LI is considered one of the most useful proliferation indices . Moreover, we have demonstrated that p27 Kip1 , a negative regulator of the cell cycle, is decreased in cases with biologically aggressive phenotypes featuring portal invasion, poor differentiation, larger tumor size and intrahepatic metastasis .…”

“…Ki-67 antigen is known to be preferentially expressed during all active phases of the cell cycle and the Ki-67 LI is considered one of the most useful proliferation indices. [39][40][41] Moreover, we have demonstrated that p27 Kip1 , a negative regulator of the cell cycle, 42 is decreased in cases with biologically aggressive phenotypes featuring portal invasion, poor differentiation, larger tumor size and intrahepatic metastasis. 22,24,43,44 Because immunohistochemical analysis is used widely in routine clinical settings, Ki-67 and p27 Kip1 can be very helpful to diagnose tumors with poor differentiation and aggressive behavior.…”

Radiofrequency ablation technique in the treatment of liver tumours: review and future issues

“…To date, the expandable RF needle electrodes have been actively studied using computational approaches both in vivo [9,[23][24][25][26] and in vitro modelling [17] and it also has been used in clinical situations [27][28][29]. Some manufacturers have already marketed equipment that consists of a 14-or 15-gauge insulated outer needle that houses seven or nine retractable curved prongs of various lengths [7].…”