Role of radiofrequency ablation in unresectable hepatocellular carcinoma: An Indian experience

• Published in: The Indian journal of radiology & imaging Vol. 23; no. 2; pp. 139 - 144
• Main Authors: Kalra, Naveen, Kang, Mandeep, Bhatia, Anmol, Duseja, Ajay K, Dhiman, Radha K, Arya, Virendra K, Rajwanshi, Arvind, Chawla, Yogesh K, Khandelwal, Niranjan
• Format: Journal Article
• Language: English
• Published: A-12, Second Floor, Sector -2, NOIDA -201301, India Thieme Medical and Scientific Publishers Private Ltd 01.04.2013; Medknow Publications; Medknow Publications and Media Pvt. Ltd; Georg Thieme Verlag Stuttgart; Medknow Publications & Media Pvt Ltd; Thieme Medical and Scientific Publishers Pvt. Ltd
• Subjects: Ablation (Surgery); Care and treatment; hcc; Health aspects; Hepatoma; Liver cancer; Liver diseases; ORIGINAL ARTICLE; rfa; Risk factors; small; unresectable; Vascular and Interventional Radiology Mini Symposia; India; small; HCC; RFA; unresectable
• ISSN: 0971-3026; 0970-2016; 1998-3808
• DOI: 10.4103/0971-3026.116569

Abstract Aims: To evaluate the role of radiofrequency ablation (RFA) as an ablative technique in patients with unresectable hepatocellular carcinoma (HCC). Settings and Design: A tertiary care center, prospective study. Materials and Methods: The subjects comprised 31 patients (30 males, one female; age range 32-75 years) with HCC (41 lesions) who were treated with image-guided RFA. The follow-up period ranged from 3 months to 6 years, and included a multiphasic computed tomography (CT) at 1, 3 and 6 months post-RFA, and every 6 months thereafter. Patient outcome was evaluated and the tumor recurrence, survival and complications were assessed. Statistical Analysis Used: Discrete categorical data were presented as n (%) and continuous data as mean ± SD. Pearson correlation coefficient was used to determine the relationship between the different variables. Kaplan-Meier survival curve and Log-rank test were used to test the significance of difference between the survival time of the different groups. Results: The ablation success rate was 80.5% (33/41 HCC lesions). 12.2% (5/41) of the lesions were managed with repeat RFA due to tumor residue. 4.9% (2/41) of the lesions were managed with repeated RFA and transarterial chemoembolization. Eight patients had tumor recurrence (five patients (16.1%) had local recurrence and three patients (9.6%) had distant recurrence). Eleven patients died within 3.5-20 months post-RFA. The survival rate at 1 year in patients who completed at least 1 year of follow-up was 63.3%. There was one major complication (1/31, 3.2%) in a patient with a subcapsular lesion and ascites. This patient developed hemoperitoneum in the immediate postprocedure period and was managed with endovascular treatment. She, however, had hepatic decompensation and died 48 h post-RFA. Conclusion: RFA is an effective and safe treatment for small unresectable HCC.