Efficacy of laparoscopic radiofrequency ablation for hepatocellular carcinoma compared to percutaneous radiofrequency ablation with artificial ascites.
OBJECTIVE
Hepatocellular carcinoma (HCC) nodules close to the liver surface exhibit high recurrence compared to those in distal parts of the liver. Moreover, when nodules remain adjacent to the gastrointestinal tract or gallbladder, severe complications such as perforation of those organs may occur due to invasive therapy. Percutaneous radiofrequency ablation (PRFA) with artificial ascites or laparoscopic radiofrequency ablation (LRFA) are used to treat these patients to avoid complications. The purpose of the present study was to assess the efficacy and safety of these two methods.


METHODS
Subjects comprised 74 patients (48 men, 26 women; mean age, 68.5 +/- 8.0 years; range, 46-89 years) with 86 HCC nodules. PRFA with artificial ascites was carried out for 37 patients (44 nodules) and LRFA was used for 37 patients (42 nodules). Clinical profiles were compared between groups.


RESULTS
No significant differences in clinical profiles were found between patients treated by PRFA or LRFA. Mean number of treatments was significantly lower for LRFA (1.0 +/- 0.0) than for PRFA (2.1 +/- 1.0, P < 0.001). Mean number of PRFA treatments was 2.2 +/- 1.0 in patients with HCC nodules >2 cm in diameter, whereas all tumors were completely ablated with only one session of LRFA. The safety margin was significantly wider for LRFA than for PRFA.


CONCLUSIONS
LRFA is a better treatment option for ablation of HCC nodules >2.0 cm in diameter.
Hirooka
Masashi
M
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan. masashih@m.ehime-u.ac.jp
Kisaka
Yoshiyasu
Y
Uehara
Takahide
T
Ishida
Kiyotaka
K
Kumagi
Teru
T
Watanabe
Yuji
Y
Abe
Masanori
M
Matsuura
Bunzo
B
Hiasa
Yoichi
Y
Onji
Morikazu
M
D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome