title: Radiofrequency ablation for the treatment of bone metastases from hepatocellular carcinoma.
abstract: OBJECTIVE
  The objective of our study was to retrospectively evaluate the clinical utility of bone radiofrequency ablation in patients with bone metastases from hepatocellular carcinoma (HCC).
  
  
  METHODS
  At three institutions, 40 consecutive HCC patients with 54 bone metastases received radiofrequency ablation. The mean maximum diameter of the bone metastases was 4.8 +/- 2.3 (SD) cm (range, 1.0-12.0 cm). The feasibility and safety of the procedure and the pain relief achieved from the procedure were reviewed. Technical success was defined as correct placement of the radiofrequency electrode into the tumor target and completion of the planned ablation protocol. Survival and prognostic factors were evaluated.
  
  
  RESULTS
  Technical success was 100%. No major complication occurred aside from transient nerve injury in one patient (2.5%, 1/40). Pain relief was achieved in all patients with painful bone metastases except one (96.6%, 28/29). The respective 1-, 2-, and 3-year survival rates were 34.2% (95% CI, 19.2-49.1), 19.9% (95% CI, 7.0-32.8), and 10.0% (95% CI, 0-20.2), with a median survival time of 7.1 months. Complete ablation of bone metastases, a single bone lesion, negative alpha-fetoprotein levels, and the absence of viable intrahepatic lesions were significant factors for a better prognosis. The median survival time was, respectively, 12.5 months in 16 patients with negative alpha-fetoprotein levels, 16.8 months in 12 patients with complete tumor ablation, 16.8 months in 16 patients with a single bone metastasis, and 21.9 months in 17 patients with no viable intrahepatic HCCs.
  
  
  CONCLUSIONS
  Bone radiofrequency ablation is a safe, useful, and feasible therapeutic option for relieving pain in patients with HCC bone metastases. Prognostic factors reported herein can facilitate stratification of patients with HCC bone metastases.
authors.affiliation: Department of Radiology, Mie University School of Medicine, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Kashima
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yamakado
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Takaki
authors.forename: Toshio
authors.initials: T
authors.lastname: Kaminou
authors.forename: Noboru
authors.initials: N
authors.lastname: Tanigawa
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Nakatsuka
authors.forename: Kan
authors.initials: K
authors.lastname: Takeda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000556:secondary / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000556:secondary / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011379:Prognosis; D015641:Radiography, Interventional; D012044:Regression Analysis; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome