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10.1245/s10434-007-9733-9
Annals of Surgical Oncology 15:782-790 (2008)
© 2008 Society of Surgical Oncology
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Original Article

Incomplete Ablation After Radiofrequency Ablation of Hepatocellular Carcinoma: Analysis of Risk Factors and Prognostic Factors

Vincent Wai-To Lam, MS, FRACS1,3, Kelvin K. Ng, MBBS (HK), PhD, FRCS (Edin)1, Kenneth Siu-Ho Chok, MBBS (HK), FRCS (Edin)1, Tan-To Cheung, MBBS (HK), FRCS (Edin)1, Jimmy Yuen, MBBS (HK), FRCR2, Helen Tung, MBBS (HK), FRCR2, Wai-Kuen Tso, MBBS (HK), FRCR2, Sheung-Tat Fan, MS, MD, PhD, FRCS (Edin & Glasg), FACS1 and Ronnie T. P. Poon, MS, PhD, FRCS (Edin), FACS1

1 Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China
2 Department of Radiology, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China
3 Cancer Institute, NSW, Australia

Correspondence: Address correspondence and reprint requests to: Ronnie T. P. Poon, MS, PhD, FRCS (Edin), FACS; E-mail: poon-tp{at}hkucc.hku.hk

Background: Complete ablation rates after a single session of radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) vary from 48% to 97%. Limited data are available regarding risk factors and prognostic significance of incomplete ablation.

Methods: Between April 2001 and March 2006, 298 patients underwent RFA of 393 HCC nodules with an intent of complete ablation after a single session. Risk factors for incomplete ablation and its effect on overall survival were analyzed.

Results: Two hundred seventy-three (91.6%) underwent complete tumor ablation, whereas the other 25 (8.4%) underwent incomplete tumor ablation after a single session of RFA. By multivariate analysis, tumor size >3 cm (P = .049) was found to be the only independent risk factor for incomplete ablation. There was no statistically significant difference in overall survival between patients with complete and incomplete ablation. By univariate analysis, no previous transarterial chemoembolization (TACE), preoperative serum alfafetoprotein ≤ 100 µ g/mL, and complete response after further treatment of incomplete ablation were associated with better overall survival in patients with incomplete ablation.

Conclusions: This study demonstrated that incomplete ablation after RFA of HCC was associated with tumor size >3 cm. Our data also suggest that aggressive further treatment of tumors with incomplete ablation aiming at complete tumor response improves overall survival.

Key Words: Hepatocellular carcinoma • Radiofrequency ablation • Residual • Risk factors • Prognosis






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