title: Percutaneous radiofrequency ablation for pulmonary metastases from hepatocellular carcinoma: results of a multicenter study in Japan.
abstract: OBJECTIVE
  To retrospectively evaluate technical success, effectiveness, complications, patient survival, and prognostic factors with percutaneous radiofrequency (RF) ablation for pulmonary metastases resulting from hepatocellular carcinoma (HCC).
  
  
  METHODS
  Thirty-two patients from six institutions were included, with a total of 83 pulmonary metastases treated in 65 sessions. RF ablation was always performed percutaneously with computed tomography (CT) guidance. Primary endpoints were technical success and technique effectiveness. Technique effectiveness was evaluated based on sequential follow-up CT images. Secondary study endpoints were complications, patient survival, and determination of prognostic factors. Complications were classified as major or minor. Prognostic factors were determined by analyzing multiple variables with the log-rank test.
  
  
  RESULTS
  Technical success rate was 100%. Primary technique effectiveness rates were 92% each at 1, 2, and 3 years. Major and minor complications occurred after 16 (25%) and 23 (35%) of the 65 sessions, respectively. The median follow-up period was 20.5 months. Overall survival rates were 87% at 1 year and 57% each at 2 and 3 years (median and mean survival times, 37.7 mo and 43.2 mo, respectively). Significantly better survival rates were obtained in cases of (i) no viable intrahepatic recurrence (P < .001), (ii) Child-Pugh class A disease (P < .001), (iii) absence of liver cirrhosis (P < .001), (iv) absence of hepatitis C virus infection (P = .006), and (v) α-fetoprotein level of 10 ng/mL or lower (P = .007) at the time of RF ablation.
  
  
  CONCLUSIONS
  RF ablation appears effective, with an acceptable safety profile, in selected patients with pulmonary metastases resulting from HCC.
authors.affiliation: Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Okayama City, Okayama 700-8558, Japan. takaoh@tc4.so-net.ne.jp
authors.forename: Takao
authors.initials: T
authors.lastname: Hiraki
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yamakado
authors.forename: Osamu
authors.initials: O
authors.lastname: Ikeda
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Matsuoka
authors.forename: Toshio
authors.initials: T
authors.lastname: Kaminou
authors.forename: Takuji
authors.initials: T
authors.lastname: Yamagami
authors.forename: Hideo
authors.initials: H
authors.lastname: Gobara
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Mimura
authors.forename: Koichi
authors.initials: K
authors.lastname: Kawanaka
authors.forename: Kan
authors.initials: K
authors.lastname: Takeda
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Inoue
authors.forename: Toshihide
authors.initials: T
authors.lastname: Ogawa
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Nishimura
authors.forename: Susumu
authors.initials: S
authors.lastname: Kanazawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome