title: Radiofrequency ablation of unresectable liver tumors: factors associated with incomplete ablation or local recurrence.
abstract: BACKGROUND
  Radiofrequency ablation (RFA) of liver tumors is associated with a risk of incomplete ablation or local recurrence.
  
  
  METHODS
  One hundred sixty-eight patients with 311 unresectable liver tumors were included. Effects of different variables on incomplete ablation and local recurrence were analyzed.
  
  
  RESULTS
  There were 132 hepatocellular carcinomas and 179 liver metastases. Tumor size was 24 (±13) mm. Two hundred twenty-six tumors were treated percutaneously, and 85 through open approach (associated with liver resection in 42 cases). There was no mortality. Major morbidity rate was 7%. Incomplete ablation and local recurrence rates were 14% and 18.6%. Follow-up was 29 months. On multivariate analysis, factors associated with incomplete ablation were tumor size (>30 mm vs ≤30 mm, P = .004) and approach (percutaneous vs open, P = .0001). Factors associated with local recurrence were tumor size (>30 mm vs ≤30 mm, P = .02) and patient age (>65 years vs ≤65 years, P = .05).
  
  
  CONCLUSIONS
  RFA is effective to treat unresectable liver tumors. However, there is a risk of incomplete ablation when percutaneously treating tumors >30 mm. When tumor ablation is completely achieved, the main factor associated with local recurrence is tumor size >30 mm.
authors.affiliation: Department of Surgery, Nancy-Brabois Hospital, Faculty of Medicine, University of Nancy, Nancy, France. a.ayav@chu-nancy.fr
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ayav
authors.forename: Adeline
authors.initials: A
authors.lastname: Germain
authors.forename: Frederic
authors.initials: F
authors.lastname: Marchal
authors.forename: Ioannis
authors.initials: I
authors.lastname: Tierris
authors.forename: Valérie
authors.initials: V
authors.lastname: Laurent
authors.forename: Christophe
authors.initials: C
authors.lastname: Bazin
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Yuan
authors.forename: Laurence
authors.initials: L
authors.lastname: Robert
authors.forename: Laurent
authors.initials: L
authors.lastname: Brunaud
authors.forename: Laurent
authors.initials: L
authors.lastname: Bresler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome