Computed Tomography-guided Radiofrequency Ablation of Hepatocellular Carcinoma: Treatment Efficacy and Complications

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Fotios Laspas¹, Evangelia Sotiropoulou¹, Sophia Mylona², Anita Manataki¹, Paraskevi Tsagouli¹, Iris Tsangaridou¹, Loukas Thanos¹

1) Department of Radiology, Sotiria Hospital Athens;
2) Department of Radiology, Red Cross Hospital Athens, Greece

Abstract

Aim: To evaluate the efficacy and complications of computed tomography (CT)-guided radiofrequency ablation (RFA) of unresectable hepatocellular carcinoma (HCC).

Methods: A retrospective study of 282 patients (231 males, 51 females, age range: 44-76 years, mean age: 62 years) with HCC (322 lesions) who had been treated by CT-guided RFA over a period of 5 years, was performed. The diameter of the tumors ranged from 1.5 to 5cm. The tumors were considered as ablated completely, if no viability was found on dual-phase dynamic contrast enhanced CT at 1 month after RFA. The follow-up period ranged from 6 to 68 months (mean 29 months) and included a dual-phase dynamic contrast enhanced CT at 1, 3 and 6 months post-RFA and every 6 months afterwards. Patient outcome was evaluated and the survival and recurrence rates were assessed. Each case was reviewed for short-term and long-term complications.

Results: The ablation success rate was 87.3% (281/322 HCC nodules), while 41 (12.7%) lesions were managed with repeated RFA because of tumor residue. The survival rates at 1, 2, 3, 4 and 5 years were 94.8%, 86.6%, 73.1%, 64.2% and 51.1%, respectively. A total number of 9 (2.8% per procedure) minor complications occurred. No major complications were observed. During the follow-up period, the local tumour progression rate was 22%, while the recurrence rate of new intrahepatic nodules was 48%.

Conclusion: The results of this study support that RFA is an effective and safe technique for the treatment of unresectable HCC.

Key words
Radiofrequency ablation - hepatocellular carcinoma - liver - computed tomography - CT-guided.