title: Radiofrequency ablation for HCC patients with multifocal tumours meeting the Milan criteria: A single-centre experience.
abstract: BACKGROUND
  Radiofrequency ablation (RFA) has been recommended as a curative treatment for patients with single early-stage unifocal hepatocellular carcinomas (HCCs) for years; however, the effect of this treatment on multifocal tumours has remained uncertain.
  
  
  OBJECTIVE
  We conducted a retrospective study to evaluate the overall survival (OS) and recurrence-free survival (RFS) rates of early HCC patients with multiple tumours subjected to different RFA modalities.
  
  
  METHODS
  One hundred fifty-four HCC patients with multifocal tumours who met the Milan criteria and underwent RFA were enrolled in this study. We divided the patients into 3 groups according to the surgical approach utilised (percutaneous, laparoscopic and open RFA; selection was based on the locations of the tumours for whether they were adhered to the subhepatic inferior vena cava or the gastrointestinal tract) and into 2 subgroups according to the tumour numbers and locations.
  
  
  RESULTS
  No deaths occurred in the 30-day post-operation period, and there were no significant differences in the complication, OS or RFS rates between the 3 groups. The 1-, 3- and 5-year OS rates were 88.9%, 75.5% and 50.9% in the subgroup with 2 tumours, respectively, versus 91.3%, 56.3% and 17.5% in the subgroup with 3 tumours, respectively (P=0.001). The corresponding values were 93.2%, 77.4% and 50.8% in the subgroup with tumours in the same segment and 82.4%, 54.8% and 23.0% in the subgroup with tumours in different segments (P=0.001).
  
  
  CONCLUSIONS
  RFA was proven to be an effective and safe method for the treatment of multifocal HCCs. Among the patients with 2 tumours within the same segment, RFA achieved better long-term outcomes in terms of both overall and recurrence-free survival.
authors: Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
authors: Wei
authors: W
authors: Zhang
authors: Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China. Electronic address: jl339@126.com.
authors: Li
authors: L
authors: Jiang
authors: Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
authors: Lunan
authors: L
authors: Yan
authors: Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
authors: Jiayin
authors: J
authors: Yang
authors: Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
authors: Bo
authors: B
authors: Li
authors: Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
authors: Tianfu
authors: T
authors: Wen
authors: Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
authors: Yong
authors: Y
authors: Zeng
authors: Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
authors: WenTao
authors: W
authors: Wang
authors: Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
authors: Mingqing
authors: M
authors: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D002681:China; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
keywords: Hepatocellular carcinoma; Multifocal tumours; Overall survival; RFA