Radiofrequency ablation of hepatocellular carcinoma: Mono or multipolar?

Abstract

Compared to monopolar radiofrequency, multipolar radiofrequency improves tumor ablation with a subsequent lower rate of local tumor recurrence.

HabibTM 4X-assisted resection versus clamp-crush resection for hepatocellular carcinoma: a propensity-matching study

“…[9, 10] We surmised that the HabibTM 4X, a bipolar ablation device, produce a better coagulative necrosis zone than with monopolar ablation. [31]…”

Three-Dimensional Measurement of Hepatocellular Carcinoma Ablation Zones and Margins for Predicting Local Tumor Progression

“…However, despite progress in RF devices (3)(4)(5)(6), the prognosis of cirrhotic patients with HCC treated by RF ablation as first-line is still impaired by local tumor progression (LTP) occurring within 2 years after RF ablation (7).…”

“…LTP occurs in 10%-21% of patients and is associated with poor prognosis (2,6). The likelihood of local progression increases with tumor size as a result of satellite nodules (8), which is why a 5-mm minimum ablation margin is recommended by several studies (9,10).…”

Clinical utility of multipolar ablation with a 3‐D simulator system for patients with liver cancer

“…Shiina et al noted that other reports regarded monopolar RFA as a reliable technology for inducing complete ablation of HCC, including sufficient safety margins, whereas another report found a 4% primary RF failure rate and 20% local tumor progression rate with monopolar RFA . Multipolar ablation systems with bipolar electrodes have recently become available . A recent report demonstrated 50% complete necrosis (on explant livers) for HCC ≤ 3 cm in diameter using monopolar RFA, compared with almost 90% using multipolar RFA .…”

“…Multipolar RFA offers the advantage of providing a large volume of ablation, providing more homogeneous necrosis with a higher rate of pathological complete necrosis . Although very encouraging results have been reported for multipolar RFA, the monopolar technique remains by far the most frequently used technique worldwide. One reason is that appropriate insertion of multiple electrodes around the tumor is very difficult, even for experts .…”