Abstract
Radiofrequency ablation (RFA) is recommended as a first-line therapy for small hepatocellular carcinoma (HCC). Tumor location is a potential factor influencing the procedure of RFA. To compare oncologic outcomes of RFA for different tumor locations, this retrospective study enrolled 194 patients with small HCC who had undertaken RFA. The HCC nodules were classified as peri-hepatic-vein (pHV) or non-pHV, peri-portal-vein (pPV) or non-pPV, and subcapsular or non-subcapsular HCC. The regional recurrence-free survival (rRFS), overall survival (OS), recurrence-free survival (recurrence in any location, RFS) and distant recurrence-free survival (dRFS) were compared. Operation failures were recorded in five pPV HCC patients, which was more frequent than in non-pPV HCC patients (p = 0.041). The 1-, 3-, and 5-year rRFS was 68.7%, 53.7%, and 53.7% for pHV patients and 85.1%, 76.1%, and 71.9% for non-pHV patients, respectively (p = 0.012). After propensity score matching, the 1-, 3-, and 5-year rRFS was still worse than that of non-pHV patients (p = 0.013). The OS, RFS, and dRFS were not significantly different between groups. Conclusions: A pHV location was a risk factor for the regional recurrence after RFA in small HCC patients. The tumor location may not influence OS, RFS, and dRFS. Additionally, a pPV location was a potential high-risk factor for incomplete ablation.
Highlights
Liver cancer is one of the most common malignancies worldwide, with an estimated 782,500 new liver cancer cases and 745,500 deaths having occurred worldwide in 2012 [1]
There were 154 patients initially diagnosed as hepatocellular carcinoma (HCC), and the remaining 40 patients were diagnosed with recurrent HCC 2 years or longer after initial radical treatments
In the present retrospective study, we evaluated the roles of tumor location relative to liver capsule and large vessels in the oncologic outcomes after Radiofrequency ablation (RFA) treatment
Summary
Liver cancer is one of the most common malignancies worldwide, with an estimated 782,500 new liver cancer cases and 745,500 deaths having occurred worldwide in 2012 [1]. Hepatocellular carcinoma (HCC) is the most frequent primary liver malignancy. Radiofrequency ablation (RFA) has been recognized as a minimally invasive procedure that is as comparably effective as liver resection for small HCCs, and it was recommended as a first-line therapy for small HCCs [2,3,4]. Tumor location is a potential factor influencing the procedural success of RFA treatment [5,6]. Being close to a large vessel or the liver capsule is potentially a high-risk location for RFA. A large vessel may drag thermal energy away during RFA targeting a perivascular tumor. This effect is called heat-sink effect and is regarded as a high-risk factor for incomplete ablation. Whether a high-risk location will affect the recurrence and overall survival is still controversial [5,6,7,8,9]
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