title: Effect of one-off complete tumor radiofrequency ablation on liver function and postoperative complication in small hepatocellular carcinoma.
abstract: OBJECTIVE
  Radiofrequency ablation (RFA) is effective in treating hepatocellular carcinoma (HCC) and less invasive than surgical resection. However, 'one-off' complete tumor ablation on liver function has not been reported.
  
  
  METHODS
  We retrospectively reviewed 36 HCCs which met the criteria of 'one-off' complete tumor ablation: (1) tumor was completed covered by the ablated zone (confirmed by postoperative enhanced CT) with a single RFA and, (2) no sign of recurrence for at least 6 months. We categorized tumors into two groups: near vascular tumor (NVT) if the distance was less than 5 mm, and far vascular tumor (FVT) otherwise.
  
  
  RESULTS
  Thirteen HCCs met the criteria of NVTs, and 23 HCCs met that of FVTs. The Average tumor size was 2.6 ± 0.3 cm in FVTs and 2.5 ± 0.3 cm in NVTs. Although restored to normal range by postoperative day (POD) 7, ALT, AST, total bilirubin (TB), albumin and prothrombin time showed more significant fluctuation in NVTs compared to those in FVTs on POD1 through POD5. Moreover, 53.9% (7/13) patients in NVT group and 26.1% (6/23) in FVT group developed post-RFA transient ascites (OR = 5.1, 95% CI = 1.1-24.4). Incidence of post-RFA pleural effusion were 61.5% (8/13) in NVT but only 17.4% (4/23) in FVTs (OR = 7.6, 95% CI = 1.6-35.9).
  
  
  CONCLUSIONS
  'One-off' complete tumor ablation may impair liver function and led to more postoperative complication if a tumor is within 5 mm away from a large blood vessel (≥ 3 mm). Particular caution should be made in preoperative assessment on the anatomic relation between tumor and large blood vessel for patients.
authors.affiliation: Institute & Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical Academy, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China. Electronic address: jiangk301@126.com.
authors.forename: K
authors.initials: K
authors.lastname: Jiang
authors.affiliation: Institute & Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical Academy, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: J
authors.initials: J
authors.lastname: Dong
authors.affiliation: Institute & Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical Academy, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: W
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Institute & Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical Academy, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Institute & Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical Academy, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: M
authors.initials: M
authors.lastname: Su
authors.affiliation: Institute & Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical Academy, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: X
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Institute & Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical Academy, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Surgery, Boston Medical Center and, Boston University School of Medicine, 715 Harrison Ave., Boston, MA 02118, USA.
authors.forename: M
authors.initials: M
authors.lastname: Yao
authors.affiliation: Institute & Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical Academy, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Huang
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008099:Liver / Q000378:metabolism*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D011517:Prothrombin Time; D012189:Retrospective Studies; D012709:Serum Albumin; D016896:Treatment Outcome
chemical_list: D012709:Serum Albumin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin
keywords: Deep sited tumor; Heat Sink Effect; Large blood vessel; Liver function; Liver parenchyma; One-off complete tumor ablation; Postoperative complication; Radiofrequency ablation; River Flow Effect; Small hepatocellular carcinoma; Superficial tumor