Percutaneous Radiofrequency Ablation Therapy of Hepatocellular Carcinoma Using Multitined Expandable Electrodes: Comparison of Subcapsular and Nonsubcapsular Tumors

Cho, Yun Ku; Rhim, Hyunchul; Ahn, Yong Sik; Kim, Mi Young; Lim, Hyo Keun

doi:10.2214/ajr.04.1346

Cited by 18 publications

(9 citation statements)

References 27 publications

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“…The reason for the differences with our study is that they routinely used artificial pleural effusion for cases with tumors abutting the diaphragm or artificial ascites in cases when tumors abutted the gastrointestinal tract. In addition, our results for the local tumor progression rate were contrary to recent studies using a control group by Kim et al (13), Cho et al (22), and Sartori et al (23). Kim et al reported no significant difference in the local tumor progression rate between subcapsular HCCs and nonsubcapsular HCCs.…”

Section: Discussioncontrasting

confidence: 99%

Percutaneous Radiofrequency Ablation for the Hepatocellular Carcinoma Abutting the Diaphragm: Assessment of Safety and Therapeutic Efficacy

et al. 2009

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ObjectiveTo assess the safety and therapeutic efficacy of a percutaneous radiofrequency (RF) ablation for the hepatocellular carcinoma (HCC) abutting the diaphragm.Materials and MethodsWe retrospectively assessed 80 patients who underwent a percutaneous RF ablation for a single nodular (< 4 cm) HCC over the last four years. Each patient underwent an ultrasound-guided RF ablation using internally cooled electrodes for the first-line treatment. We divided patients into two subgroups based on whether the index tumor was abutting (less than 5 mm) the diaphragm or not: group A (abutting; n = 31) versus group B (non-abutting; n = 49). We compared the two subgroups for complications and therapeutic efficacy using image and the review of medical records. The statistical assessment included an independent t-test, Fisher's exact test, and chi-square test.ResultsThe assessment of the diaphragmatic swelling at CT immediately following the procedure was more severe in group A than group B (mean thickness change:1.44 vs. 0.46 mm, p = 0.00). Further, right shoulder pain was more common in group A than B (p = 0.01). Although minor complications (hemothorax 1 case, pleural effusion 1 case) were noted only in group A, no major thoracic complication occurred in either group. The technical success rate was lower in group A than group B (84% vs. 98%, p = 0.03). As well, the primary and secondary technique effectiveness rates in group A and group B were 90% versus 98% (p = 0.29) and 79% versus 91% (p = 0.25), respectively. The local tumor progression rate was higher in group A than in group B (29% vs. 6%, p = 0.02).ConclusionWe found that the percutaneous RF ablation for the HCC abutting the diaphragm is a safe procedure without major complications. However, it is less effective with regard to technical success and local tumor control.

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Section: Discussioncontrasting

confidence: 99%

Percutaneous Radiofrequency Ablation for the Hepatocellular Carcinoma Abutting the Diaphragm: Assessment of Safety and Therapeutic Efficacy

et al. 2009

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“…The local recurrence rate of HCC, after segmental TACE, reported in prior studies has been around 30% (9). RF ablation therapy has been previously used primarily for the treatment of small nodular HCC tumors (16, 18-22). The local recurrence rate of small HCCs after RF ablation has been reported to be around 10-20% (16, 18-22).…”

Section: Discussionmentioning

confidence: 99%

“…RF ablation therapy has been previously used primarily for the treatment of small nodular HCC tumors (16, 18-22). The local recurrence rate of small HCCs after RF ablation has been reported to be around 10-20% (16, 18-22). Therefore, the 11.1% estimated 3-year local recurrence rate in Group IA can be regarded as acceptably low.…”

Section: Discussionmentioning

confidence: 99%

Local Recurrence of Hepatocellular Carcinoma after Segmental Transarterial Chemoembolization: Risk Estimates Based on Multiple Prognostic Factors

et al. 2007

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ObjectiveTo determine the prognostic factors for local recurrence of nodular hepatocellular carcinoma after segmental transarterial chemoembolization.Materials and MethodsSeventy-four nodular hepatocellular carcinoma tumors ≤ 5 cm were retrospectively analyzed for local recurrence after segmental transarterial chemoembolization using follow-up CT images (median follow-up of 17 months, 4-77 months in range). The tumors were divided into four groups (IA, IB, IIA, and IIB) according to whether the one-month follow-up CT imaging, after segmental transarterial chemoembolization, showed homogeneous (Group I) or inhomogeneous (Group II) iodized oil accumulation, or whether the tumors were located within the liver segment (Group A) or in a segmental border zone (Group B). Comparison of tumor characteristics between Group IA and the other three groups was performed using the chi-square test. Local recurrence rates were compared among the groups using the Kaplan-Meier estimation and log rank test.ResultsLocal tumor recurrence occurred in 19 hepatocellular carcinoma tumors (25.7%). There were: 28, 18, 17, and 11 tumors in Group IA, IB, IIA, and IIB, respectively. One of 28 (3.6%) tumors in Group IA, and 18 of 46 (39.1%) tumors in the other three groups showed local recurrence. Comparisons between Group IA and the other three groups showed that the tumor characteristics were similar. One-, two-, and three-year estimated local recurrence rates in Group IA were 0%, 11.1%, and 11.1%, respectively. The difference between Group IA and the other three groups was statistically significant (p = 0.000).ConclusionAn acceptably low rate of local recurrence was observed for small or intermediate nodular tumors located within the liver segment with homogeneous iodized oil accumulation.

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“…Various types of risk factors for local tumor progression have been proposed in different studies, with controversial results [11][12][13][14][15][16][17][18]. Several independent risk factors for local tumor progression proposed in the previous investigations related to the geometry of the ablation zone and liver anatomy including lack of peritumoral ablative margin, heat sink effect of contiguous vessels, and subcapsular location.…”

Section: Patient Populationmentioning

confidence: 99%

Local Tumor Progression After Radiofrequency Ablation of Liver Tumors: Analysis of Morphologic Pattern and Site of Recurrence

Kei

Rhim

Choi

et al. 2008

American Journal of Roentgenology

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Percutaneous Radiofrequency Ablation Therapy of Hepatocellular Carcinoma Using Multitined Expandable Electrodes: Comparison of Subcapsular and Nonsubcapsular Tumors

Abstract: The rates of local tumor progression and complications for radiofrequency ablation using multitined expandable electrodes for subcapsular hepatocellular carcinomas were comparable to those for nonsubcapsular hepatocellular carcinomas.

Cited by 18 publications

References 27 publications

Percutaneous Radiofrequency Ablation for the Hepatocellular Carcinoma Abutting the Diaphragm: Assessment of Safety and Therapeutic Efficacy

Percutaneous Radiofrequency Ablation for the Hepatocellular Carcinoma Abutting the Diaphragm: Assessment of Safety and Therapeutic Efficacy

Local Recurrence of Hepatocellular Carcinoma after Segmental Transarterial Chemoembolization: Risk Estimates Based on Multiple Prognostic Factors

Local Tumor Progression After Radiofrequency Ablation of Liver Tumors: Analysis of Morphologic Pattern and Site of Recurrence

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