Intraoperative radiofrequency ablation for hepatocellular carcinoma in 112 patients with cirrhosis: a surgeon's view.
10.4174/astr.2016.90.3.147
- Author:
Jung Yeon LEE
1
;
Young Hoon KIM
;
Young Hoon ROH
;
Kyung Bin ROH
;
Kwan Woo KIM
;
Sung Hwa KANG
;
Yang Hyun BAEK
;
Sung Wook LEE
;
Sang Young HAN
;
Hee Jin KWON
;
Jin Han CHO
Author Information
1. Department of Surgery, Dong-A University College of Medicine, Pusan, Korea. yhkim1@dau.ac.kr
- Publication Type:Original Article
- Keywords:
Hepatocellular carcinoma;
Intraoperative;
Radiofrequency ablation
- MeSH:
Ascites;
Carcinoma, Hepatocellular*;
Catheter Ablation*;
Comorbidity;
Disease-Free Survival;
Female;
Fibrosis*;
Follow-Up Studies;
Hernia, Ventral;
Humans;
Liver;
Male;
Mortality;
Multivariate Analysis;
Recurrence;
Retrospective Studies;
Venous Thrombosis
- From:Annals of Surgical Treatment and Research
2016;90(3):147-156
- CountryRepublic of Korea
- Language:English
-
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.
