title: Radiofrequency ablation of hepatocellular carcinoma: treatment success as defined by histologic examination of the explanted liver.
abstract: OBJECTIVE
  To retrospectively evaluate the effectiveness of radiofrequency (RF) ablation of hepatocellular carcinoma (HCC) by using histologic examination of the explanted liver.
  
  
  METHODS
  The study was approved by the medical center Institutional Review Board, with waiver of informed consent. Forty-seven HCC nodules in 24 patients (18 men, six women; age range, 33-71 years; mean age, 56 years) were treated with single or double RF ablation sessions prior to liver transplantation. Histologic data from hematoxylin-eosin staining of explanted liver specimens were retrospectively reviewed to determine treatment success, which was defined as the absence of residual or recurrent viable carcinoma cells at treatment site. Tumor size and the presence of large (> or =3 mm) abutting vessels that were observed during imaging were tested as potential predictors of treatment success or failure (Fisher exact test). In patients who underwent postablation computed tomographic (CT) or magnetic resonance (MR) imaging within 3 months prior to transplantation (21 patients with 44 tumors), imaging results were analyzed for sensitivity and specificity of residual or recurrent tumor by using histologic data as the reference standard.
  
  
  RESULTS
  Thirty-five (74%) of 47 ablated tumors, including 29 (83%) of 35 tumors less than 3 cm, were found to be successfully treated on the basis of histologic findings after a mean interval of 7.5 months between RF ablation and transplantation. Nodules that were successfully treated had mean maximal diameter of 2.0 cm, and nodules that were unsuccessfully treated had mean maximal diameter of 3.1 cm (P=.014). Seven (47%) of 15 perivascular lesions were successfully treated whereas 28 (88%) of 32 nonperivascular lesions were successfully treated (P <.01). Imaging correlation showed 100% (33 of 33) specificity and 36% (four of 11) sensitivity of postablation CT and MR imaging for the depiction of residual or recurrent tumor.
  
  
  CONCLUSIONS
  Histologic evidence directly validates RF ablation as an effective treatment of small (<3 cm) HCC.
authors.affiliation: Department of Radiology, UCLA School of Medicine, 10833 LeConte Ave, Los Angeles, CA 90095-1721, USA.
authors.forename: David S K
authors.initials: DS
authors.lastname: Lu
authors.forename: Nam C
authors.initials: NC
authors.lastname: Yu
authors.forename: Steven S
authors.initials: SS
authors.lastname: Raman
authors.forename: Piyaporn
authors.initials: P
authors.lastname: Limanond
authors.forename: Charles
authors.initials: C
authors.lastname: Lassman
authors.forename: Kathryn
authors.initials: K
authors.lastname: Murray
authors.forename: Myron J
authors.initials: MJ
authors.lastname: Tong
authors.forename: Rafael G
authors.initials: RG
authors.lastname: Amado
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Busuttil
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D007472:Iohexol