Treatment of large and/or multiple hepatic malignancies: open surgical approaches of radiofrequency ablation.
OBJECTIVE
Patients with hepatic malignancies are often poor candidates for resection because of the lack of hepatic reserve as a result of coexisting cirrhosis or the presence of multiple tumors. The purpose of this study was to determine the safety and efficacy of open intraoperative radiofrequency ablation of unresectable hepatic malignancies with size larger than 4 cm in diameter and/or more than three in number.


METHODS
Between May 2000 and September 2003, 30 patients (24 men, 6 women; age range, 59-72 years; mean age, 63 years) with 51 hepatic malignancies. The maximal diameter of all tumors ranged from 1.0 to 10cm (mean +/- SD, 3.2 +/- 1.8).


RESULTS
All tumors achieved necrosis completely in a single session. The mean follow-up from the initial ablation in this study was 18.9 +/- 10.1 months (range, 0-41). The 1-, 2 and 3-year overall survival rates were 86.1%, 71.6% and 71.6%, respectively. The 1-, 2 and 3-year disease-free survival rates were 70.9%, 37.6% and 25.1%, respectively.


CONCLUSIONS
Open radiofrequency ablation is a safety and efficient approach for hepatic malignancies sized more than 4 cm in diameter and/or located more than three in number.
Minami
Yasunori
Y
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Japan.
Kawasaki
Toshihiko
T
Kudo
Masatoshi
M
Haji
Seiji
S
Shiraishi
Osamu
O
Kawabe
Takashi
T
Yasuda
Chikao
C
Nakai
Takuya
T
Takeyama
Yoshihumi
Y
Shiozaki
Hitoshi
H
D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation; D018572:Disease-Free Survival; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D016019:Survival Analysis