Radiofrequency thermal ablation of liver carcinoma. Prospective study of 82 lesions.
OBJECTIVE
The aim of this prospective study was to evaluate the feasibility of radiofrequency ablation of hepatic tumors. We studied the rates of mortality, morbidity, and recurrence and recorded overall and disease-free survival.


METHODS
All patients aged over 18 years with histologically proven malignant liver disease inaccessible to surgical treatment (one to four tumor localizations) were eligible for inclusion in the study. Child-Pugh score > B9, platelets count <or=50.103/mm3, prothrombin index <or=50% and pregnancy were exclusion factors.


RESULTS
Between July 2001 and June 2004, 51 patients (13 women, 38 men, mean age 66 +/- 9 years) were included and underwent 61 radiofrequency thermal ablation procedures for 82 hepatic lesions: hepatocarcinoma (N=44), cholangiocarcinoma (N=1), metastasic tumors (N=37). Hospital morbidity and mortality were 11.5% and 2% respectively. Recurrence rate at 3 years was 20.6%. In multivariate analysis, only tumor size > 3 cm was correlated significantly with recurrence (P=0.03). Actuarial 1-, 2- and 3-year survival rates in the hepatocarcinoma group (N=31) were 84.7%, 57.7% and 34.6% respectively. Actuarial 1-, 2- and 3-year survival rates in the metastasis from colorectal adenocarcinoma group (N=14) were 90%, 54% and 54% respectively (P=0.72).


CONCLUSIONS
Radiofrequency thermal ablation is an effective treatment for hepatic tumors measuring less than 3 cm. There is a low risk of complications and open surgery can be associated. However in the absence of randomized studies comparing radiofrequency and surgery, respective indications cannot be defined in detail.
Lermite
Emilie
E
Service de Chirurgie Viscérale, CHU Angers.
Lebigot
Jérôme
J
Oberti
Frédéric
F
Pessaux
Patrick
P
Aube
Christophe
C
Cales
Paul
P
Arnaud
Jean-Pierre
JP
D000368:Aged; D017115:Catheter Ablation; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D016896:Treatment Outcome