Radiofrequency ablation of high-grade dysplastic nodules in chronic liver disease: comparison with well-differentiated hepatocellular carcinoma based on long-term results

Abstract

This retrospective study compared the long-term results of percutaneous radiofrequency (RF) ablation for high-grade dysplastic nodules (DNs) and well-differentiated hepatocellular carcinomas (HCCs). Between April 1999 and December 2006, 20 patients with 21 high-grade DNs (range, 1.2-3.0 cm; mean, 1.9 cm) (group 1) and 49 with a well-differentiated HCC (range, 1.0-5.0 cm; mean, 2.3 cm) (group 2) underwent RF ablation. The technique effectiveness, local tumor progression, cancer-free and cumulative survivals using the Kaplan-Meier method were compared. The technique effectiveness rates at 1 year after RF ablation were 100% (19/19) and 94.1% (32/34) in groups 1 and 2, respectively (P > 0.05). The local tumor progression rates in groups 1 and 2 were 0% and 20.6% (7/34), respectively (P = 0.041). The local tumor progression in group 2 was seen on follow-up computed tomography 4-58 months (mean, 17 months) after RF ablation. The 1-, 3-, and 5-year cancer-free survival rates in groups 1 and 2 were 95.0% and 76.9%, 56.2% and 44.6%, and 38.5% and 24.8%, respectively (P > 0.05). The 1-, 3-, and 5-year cumulative survival rates in groups 1 and 2 were 100% and 97.9%, 73.0% and 68.0%, and 63.8% and 51.1%, respectively (P > 0.05). Percutaneous RF ablation is effective for treating high-grade DNs and well-differentiated HCCs. The long-term results after RF ablation of high-grade DNs may be improved compared with those of well-differentiated HCCs.

Liver Transplantation for Hepatocellular Carcinoma Without Preoperative Tumor Biopsy

“…Dysplastic nodules have not been recognized as an indication for transplantation. A close follow-up is warranted by some authors (53), whereas others propose radiofrequency ablation (54).…”

Estimated effective dose of CT-guided percutaneous cryoablation of liver tumors

“…Percutaneous radiofrequency ablation (RFA) and cryoablation are minimally invasive treatment alternatives for managing liver tumors in patients who are unable to undergo surgical resection [1–8]. CT is used often as a guidance modality for ablation because of its favorable spatial and contrast resolution and, in part, because of radiologists’ familiarity with the use of CT for guiding percutaneous needle biopsies and drainages.…”

Assessment of hepatocellular carcinomas using conventional magnetic resonance imaging correlated with histological differentiation and a serum marker of poor prognosis

“…In general, well-differentiated HCCs are fed from the portal blood flow, with tumor vascularity switching to arterial blood flow along with dedifferentiation to moderately/poorly differentiated HCC as the biological malignant potential increases [2]. The prognosis of welldifferentiated HCCs is good following resection or local therapy [3][4][5][6]. However, moderately/poorly differentiated HCCs have a greater tendency for vascular invasion and metastasis with poorer histological differentiation; the prognosis for poorly differentiated HCCs following resection or local therapy is particularly poor [7][8][9][10].…”