title: Radiofrequency ablation of hepatocellular carcinoma: long-term experience with expandable needle electrodes.
abstract: OBJECTIVE
  Our objective was to determine the efficacy of radiofrequency ablation, using expandable electrodes, in the treatment of patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  In a 5-year period (1998-2003), 68 HCCs in 59 patients (age range, 47-88 years) were treated percutaneously with radiofrequency ablation using expandable needle electrodes. The mean lesion diameter was 3.1 cm (range, 1-12 cm). Fifty-one of 59 patients were in Child-Pugh class A, and eight were in class B. Follow-up was performed by helical CT at 1, 4, and 6 months and every 6 months after that. The mean follow-up was 24.1 months (range, 6-60 months). Survival and disease-free survival rates were evaluated separately by statistical analysis. Any complications were reported during follow-up.
  
  
  RESULTS
  Cumulative survival rates were 94.4%, 65%, and 43.1% at 1, 3, and 5 years, respectively. Median survival time was 23.6 months (range, 4-62 months). Maximum tumor diameter was associated with the probability of survival: 73% among patients with lesion diameters of 3 cm or less, 76.5% among patients with lesion diameters of 3-5 cm, and only 40% among patients with lesion diameters of more than 5 cm (p = 0.05, log-rank test; p = 0.07, Tarone-Ware test). In 34 (57.6%) of 59 patients during follow-up, new nodules noncontiguous with the treated nodule developed in the liver (tumor recurrences). Median disease-free survival rates were 32.1%, 28.1%, and 17.5% at 1, 2, and 3 years, respectively. One major complication occurred (hemoperitoneum that required transfusion).
  
  
  CONCLUSIONS
  Radiofrequency ablation with expandable electrodes is safe and effective in the treatment of HCC.
authors.affiliation: Department of Radiology, University of Brescia, Piazzale Spedali Civili 1, Brescia 25100, Italy. paolocab@libero.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Cabassa
authors.forename: Francesco
authors.initials: F
authors.lastname: Donato
authors.forename: Federica
authors.initials: F
authors.lastname: Simeone
authors.forename: Luigi
authors.initials: L
authors.lastname: Grazioli
authors.forename: Laura
authors.initials: L
authors.lastname: Romanini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation*; D004566:Electrodes; D004867:Equipment Design; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009339:Needles; D015996:Survival Rate