title: Percutaneous CT-guided radiofrequency ablation for unresectable hepatocellular carcinoma pulmonary metastases.
abstract: OBJECTIVE
  This study aimed to evaluate the safety and efficacy of percutaneous CT-guided radiofrequency ablation (RFA) for unresectable hepatocellular carcinoma pulmonary metastases (HCCPM) and to identify the prognostic factors for survival.
  
  
  METHODS
  We reviewed the medical records of 320 patients with HCCPM treated between January 2005 and January 2012. Among them, 29 patients with 68 lesions of unresectable HCCPM underwent 56 RFA sessions. Safety, local efficacy, survival and prognostic factors were evaluated. Survival was analysed using the Kaplan-Meier method. Univariate analyses were evaluated by the log-rank test.
  
  
  RESULTS
  Pneumothorax requiring chest tube placement occurred in five (8.9%, 5/56) RFA sessions. During the median follow-up period of 23 months (range 6-70), 18 patients (62.1%, 18/29) died of tumour progression and 11 (37.9%, 11/29) were alive. The 1-, 2- and 3-year overall survival rates were 73.4%, 41.1% and 30%, respectively. The median progression-free survival was 18 months (95% confidence interval (CI) 9.8-26.2) and the median overall survival time was 21 months (95%CI, 9.7-32.3). The maximum tumour diameter ≤3 cm (p = 0.002), the number of pulmonary metastases ≤3 (p = 0.014), serum AFP level ≤400 ng/mL (p = 0.003), and the controlled status of intrahepatic tumour after lung RFA (p = 0.001) were favourable prognostic factors for overall survival.
  
  
  CONCLUSIONS
  Our study indicates that percutaneous CT-guided RFA, as an alternative treatment procedure to pulmonary metastasectomy, can be a safe and effective therapeutic option for unresectable HCCPM.
authors.affiliation: Minimally Invasive Interventional Division, Medical Imaging Centre, State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Centre, 651 Dongfeng Road East, Guangzhou, China.
authors.forename: Xishan
authors.initials: X
authors.lastname: Li
authors.forename: Jianpeng
authors.initials: J
authors.lastname: Wang
authors.forename: Wang
authors.initials: W
authors.lastname: Li
authors.forename: Zilin
authors.initials: Z
authors.lastname: Huang
authors.forename: Weijun
authors.initials: W
authors.lastname: Fan
authors.forename: Yumin
authors.initials: Y
authors.lastname: Chen
authors.forename: Lijie
authors.initials: L
authors.lastname: Shen
authors.forename: Tao
authors.initials: T
authors.lastname: Pan
authors.forename: Peihong
authors.initials: P
authors.lastname: Wu
authors.forename: Ming
authors.initials: M
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology; D014057:Tomography, X-Ray Computed; D055815:Young Adult