What are the reported outcomes for percutaneous radiofrequency ablation (RFA) of liver tumors?

Updated: Nov 25, 2019
  • Author: Badar Bin Bilal Shafi, MBBS, MRCP, FRCR, CCT, EBIR; Chief Editor: Kurt E Roberts, MD  more...
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One randomized controlled trial showed that the 2-year recurrence rate of HCC was significantly lower with RFA than with PEI. The recurrence rate is higher after RFA than after surgical resection, with less time to recurrence. [37]  Recurrence is more common with the percutaneous approach as compared with open or laparoscopic RFA. The rate of recurrence is also higher with lesions larger than 3 cm. [38]

In a study by Toshimori et al, the local recurrence rates after percutaneous RFA for HCC were 2.2% at 1 year, 7.4% at 3 years, and 9.5% at 5 years. [39] Factors that predisposed to local recurrence included large tumor size (>2 cm), tumor location adjacent to the major portal branch or hepatic vein), and a small (< 3 mm) ablated margin.

Shady et al assessed factors affecting outcome in patients with colorectal cancer liver metastases who were treated with percutaneous RFA. [40] On multivariate analysis, factors predictive of shorter local tumor progression-free survival were a tumor size exceeding 3 cm and a margin size of 5 mm or less; factors predictive of shorter overall survival were a tumor size exceeding 3 cm and the the presence of more than one site of extra-hepatic disease.

Yamao et al compared the survival impacts of RFA (n = 33) and hepatic resection (n = 71) as initial treatment of HCC in 104 patients with liver damage B as defined by the Liver Cancer Study Group of Japan. [41] Whereas overall survival (OS) tended to be better in the RFA group, disease-free survival (DFS) did not differ significantly between groups. Subgroup analyses found OS with RFA to be significantly better in patients with aspartate aminotransferase above 35 IU/L, serum albumin below 3.5 g/dL, and 99mTc-galactosyl human serum albumin below 0.85.

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