title: CT-guided versus laparoscopic radiofrequency ablation in recurrent small hepatocellular carcinoma against the diaphragmatic dome.
abstract: Computed tomography-guided radiofrequency ablation (CT-RFA) and laparoscopic RFA (L-RFA) have been used to treat intrahepatic recurrent small hepatocellular carcinoma (HCC) against the diaphragmatic dome. However, the therapeutic safety, efficacy, and hospital fee have never been compared between the two techniques due to scarcity of cases. In this retrospective study, 116 patients were divided into two groups with a total of 151 local recurrent HCC lesions abutting the diaphragm. We compared overall survival (OS), local tumor progression (LTP), postoperative complications, and hospital stay and fee between the two groups. Our findings revealed no significant differences in 5-year OS (36.7% vs. 44.6%, p = 0.4289) or 5-year LTP (73.3% vs. 67.9%, p = 0.8897) between CT-RFA and L-RFA. The overall hospital stay (2.8 days vs. 4.1 days, p < 0.0001) and cost (¥ 19217.6 vs. ¥ 25553.6, p < 0.0001) were significantly lower in the CT-RFA in comparison to that of L-RFA. In addition, we elaborated on the choice of percutaneous puncture paths depending on the locations of the HCC nodules and 11-year experience with CT-RFA. In conclusion, CT-RFA is a relatively easy and economic technique for recurrent small HCC abutting the diaphragm, and both CT-RFA and L-RFA are effective techniques.
authors.affiliation: Department of Radiology, The Second Affiliated Hospital of Southeast University, Southeast University, 1-1 Zhongfu Road, Nanjing, Jiangsu, 210003, China.
authors.forename: Huaiyin
authors.initials: H
authors.lastname: Ding
authors.affiliation: Department of Oncology, The Second Affiliated Hospital of Southeast University, Southeast University, 1-1 Zhongfu Road, Nanjing, Jiangsu, 210003, China.
authors.forename: Mu
authors.initials: M
authors.lastname: Su
authors.affiliation: Department of Oncology, The Second Affiliated Hospital of Southeast University, Southeast University, 1-1 Zhongfu Road, Nanjing, Jiangsu, 210003, China.
authors.forename: Chuandong
authors.initials: C
authors.lastname: Zhu
authors.affiliation: Department of Oncology, The Second Affiliated Hospital of Southeast University, Southeast University, 1-1 Zhongfu Road, Nanjing, Jiangsu, 210003, China.
authors.forename: Lixue
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Oncology, The Second Affiliated Hospital of Southeast University, Southeast University, 1-1 Zhongfu Road, Nanjing, Jiangsu, 210003, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Zheng
authors.affiliation: Department of Oncology, The Second Affiliated Hospital of Southeast University, Southeast University, 1-1 Zhongfu Road, Nanjing, Jiangsu, 210003, China.|N250, Millennium Science Complex, Pennsylvania State University, University Park, 16801, PA, USA.|Nanjing Zetect Biomedical Company, Nanjing, 210003, Jiangsu, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Wan
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003964:Diaphragm / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000473:pathology; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome