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Radiofrequency ablation for subcapsular hepatocellular carcinoma
Ronnie Tung-Ping Poon1, Kelvin Kwok-Chai Ng, Chi-Ming Lam
1Centre for the Study of Liver Disease and the Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong, China. poontp@hkucc.hku.hk
Annals of Surgical Oncology
|March 3, 2004
Summary
Radiofrequency ablation (RFA) for subcapsular hepatocellular carcinoma (HCC) shows comparable outcomes to nonsubcapsular HCC. Subcapsular HCC is not a contraindication for RFA, with similar safety and efficacy observed.
Area of Science:
- Hepatobiliary surgery
- Interventional oncology
- Radiofrequency ablation techniques
Background:
- Recent studies suggest potential risks with radiofrequency ablation (RFA) for subcapsular hepatocellular carcinoma (HCC), including bleeding, needle-track seeding, and local recurrence.
- Limited data exists on the comparative safety and efficacy of RFA for subcapsular versus nonsubcapsular HCC.
Purpose of the Study:
- To compare the outcomes of radiofrequency ablation (RFA) for subcapsular hepatocellular carcinoma (HCC) with those for nonsubcapsular HCC.
- To evaluate treatment morbidity, mortality, ablation rates, recurrence, and survival in patients undergoing RFA for subcapsular HCC.
Main Methods:
- A retrospective study comparing 80 patients with 104 HCC nodules treated with RFA between May 2001 and October 2002.
- Group I (48 patients) had subcapsular HCC, treated with indirect puncture and thermocoagulation of the needle track.
- Group II (32 patients) had nonsubcapsular HCC, treated via various approaches (celiotomy, laparoscopy, percutaneous).
Main Results:
- No significant differences were observed between subcapsular (Group I) and nonsubcapsular (Group II) HCC groups in treatment morbidity (14.6% vs. 15.6%), mortality (2.1% vs. 0%), complete ablation rates (89.4% vs. 96.9%), local recurrence rates (4.3% vs. 12.5%), recurrence-free survival, or overall survival.
- No needle-track seeding or intraperitoneal metastasis was observed after a median follow-up of 13 months.
Conclusions:
- Radiofrequency ablation (RFA) for subcapsular HCC yields results comparable to those for nonsubcapsular HCC.
- Subcapsular location should not preclude RFA as a treatment option for hepatocellular carcinoma.