Radiofrequency ablation of unresectable liver tumors: factors associated with incomplete ablation or local recurrence

• Published in: The American journal of surgery Vol. 200; no. 4; pp. 435 - 439
• Main Authors: Ayav, Ahmet, M.D., Ph.D, Germain, Adeline, M.D, Marchal, Frederic, M.D., Ph.D, Tierris, Ioannis, M.D, Laurent, Valérie, M.D, Bazin, Christophe, M.D, Yuan, Yufeng, M.D, Robert, Laurence, M.D, Brunaud, Laurent, M.D., Ph.D, Bresler, Laurent, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-10-2010; Elsevier; Elsevier Limited
• Subjects: Ablation; Adult; Aged; Aged, 80 and over; Biochemistry, Molecular Biology; Biological and medical sciences; Biophysics; Catheter Ablation - methods; Catheters; Female; Follow-Up Studies; France - epidemiology; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Hepatectomy - methods; Hepatocellular carcinoma; Humans; Incidence; Incomplete ablation; Laparoscopy; Life Sciences; Liver; Liver cancer; Liver Neoplasms - diagnosis; Liver Neoplasms - surgery; Liver tumor; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Local recurrence; Magnetic Resonance Imaging; Male; Medical imaging; Medical prognosis; Medical sciences; Metastases; Metastasis; Middle Aged; Morbidity; Multivariate analysis; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - surgery; NMR; Nuclear magnetic resonance; Other treatments; Performance evaluation; Radio frequency; Radiofrequency ablation; Retrospective Studies; Risk factors; Surgery; Tomography, X-Ray Computed; Treatment Outcome; Treatment. General aspects; Tumors; France; Incomplete ablation; Radiofrequency ablation; Liver tumor; Local recurrence; Relapse; Ultrasonic treatment; Instrumentation therapy; Thermal ablation; Hepatic disease; Radiofrequency; Medicine; Surgery; Cause; Unresectable; Digestive diseases
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2009.11.009

Abstract Background Radiofrequency ablation (RFA) of liver tumors is associated with a risk of incomplete ablation or local recurrence. Methods One hundred sixty-eight patients with 311 unresectable liver tumors were included. Effects of different variables on incomplete ablation and local recurrence were analyzed. Results There were 132 hepatocellular carcinomas and 179 liver metastases. Tumor size was 24 (±13) mm. Two hundred twenty-six tumors were treated percutaneously, and 85 through open approach (associated with liver resection in 42 cases). There was no mortality. Major morbidity rate was 7%. Incomplete ablation and local recurrence rates were 14% and 18.6%. Follow-up was 29 months. On multivariate analysis, factors associated with incomplete ablation were tumor size (>30 mm vs ≤30 mm, P = .004) and approach (percutaneous vs open, P = .0001). Factors associated with local recurrence were tumor size (>30 mm vs ≤30 mm, P = .02) and patient age (>65 years vs ≤65 years, P = .05). Conclusions RFA is effective to treat unresectable liver tumors. However, there is a risk of incomplete ablation when percutaneously treating tumors >30 mm. When tumor ablation is completely achieved, the main factor associated with local recurrence is tumor size >30 mm.