Local recurrence after laparoscopic radiofrequency ablation of malignant liver tumors: Results of a contemporary series.
BACKGROUND
The aims of this study were to determine the incidence of Local recurrence (LR) in patients at long-term follow-up after laparoscopic RFA (LRFA) and also to determine the risk factors for LR from a contemporary series.


METHODS
Patients undergoing LRFA between 2005 and 2014 by a single surgeon were reviewed. Demographic and perioperative data were analyzed from a prospective database.


RESULTS
LRFA was performed on 316 patients with 901 lesions. Median follow-up was 25 months, with 76% of whom completed at least one year of follow-up. The LR rate was 18.4%. The LR in patients followed for less than 12 months was 13.8%, 20.3% for 12 months, and 19.7% for 18 months (P = 0.02). One-fourth of the LRs developed after the 1st year. Morbidity was 8.9% and mortality 0.3%. Tumor type, size, ablation margin, and surgeon experience affected LR, with tumor type, size, and ablation margin being independent.


CONCLUSIONS
This study shows that 14% of malignant liver tumors will develop LR within a year after LRFA. Additional 4% of the lesions will demonstrate recurrence within 1 cm of the ablation zone, mostly as part of a multifocal recurrence. Ablation margin is the only parameter that the surgeon can manipulate to decrease LR.
Department of General Surgery, Cleveland Clinic, Cleveland, Ohio.
Hideo
http://orcid.org/0000-0003-3135-9457
H
Takahashi
Department of Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio.
Muhammet
M
Akyuz
Department of Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio.
Erol
E
Aksoy
Department of Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio.
Koray
K
Karabulut
Department of General Surgery, Cleveland Clinic, Cleveland, Ohio.|Department of Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio.
Eren
E
Berber
D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000628:therapy; D018278:Carcinoma, Neuroendocrine / Q000401:mortality / Q000473:pathology / Q000628:therapy; D017115:Catheter Ablation; D002983:Clinical Competence; D015179:Colorectal Neoplasms / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000628:therapy*; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D018084:Ultrasonography, Interventional
laparoscopic; malignant liver tumors; radiofrequency ablation