title: Short-Term Results of Laparoscopic Radiofrequency Ablation Using a Multipolar System for Localized Hepatocellular Carcinoma.
abstract: OBJECTIVE
  Multipolar radiofrequency ablation (RFA) is feasible for the treatment of hepatocellular carcinoma (HCC) for which a large ablative area is planned, and it imposes a light physical burden on patients. Multipolar RFA via the percutaneous approach is performed in the majority of cases, but the efficacy of multipolar RFA with a laparoscopic approach has rarely been studied. This study aimed to evaluate the efficacy and safety of multipolar laparoscopic RFA (LRA) for localized HCC over the short term.
  
  
  METHODS
  From January 2014 to January 2016, 77 consecutive patients with 130 HCCs treated by multipolar LRA were assessed. One to three bipolar needle applicators were inserted under laparoscopic ultrasonography guidance, regardless of tumor location. We intended to achieve parallel insertions and no-touch ablation as much as possible.
  
  
  RESULTS
  The median size of the main tumor was 22 mm (range, 10-42 mm). The median follow-up time was 13.6 months (range, 3.1-24.8 months). In all cases, a sufficient ablative area was obtained as planned, without thermal injury of adjacent organs. During the follow-up period, all patients were alive with no local tumor progression, while intrahepatic recurrence distant from the primary site occurred in 7 patients. The 2-year local tumor progression-free survival rate and overall cancer-free survival rate were 100 and 81.6%, respectively. There were no procedural major complications caused prolonging the hospitalization, and all patients were discharged without subjective symptoms 4-7 days after LRA.
  
  
  CONCLUSIONS
  Multipolar LRA was efficacious in the treatment of localized HCCs by safely achieving a good ablative area.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Morimoto
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Isoda
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Takaoka
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Hirosawa
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Otake
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Kozue
authors.initials: K
authors.lastname: Murayama
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fujieda
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Mamiko
authors.initials: M
authors.lastname: Tsukui
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Natsumi
authors.initials: N
authors.lastname: Miyata
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Ono
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Shota
authors.initials: S
authors.lastname: Yamaguchi
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamamoto
keywords: Hepatocellular carcinoma; Local ablation therapy; Outcome; Radiofrequency ablation; Surgery