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

  • Hepatic and Pancreatic Tumors
  • Published:
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Abstract

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 alfa-fetoprotein ≤100 μg/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.

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Acknowledgments

We thank the Sun Chi Yeh Research Foundation for Hepatobiliary and Pancreatic Surgery of the University of Hong Kong, Hong Kong, China. V.W.L. was supported by the Cancer Institute NSW International Clinical and Research Fellowship, Australia.

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Authors and Affiliations

  1. Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China

    Vincent Wai-To Lam MS, FRACS, Kelvin K. Ng MBBS (HK), PhD, FRCS (Edin), Kenneth Siu-Ho Chok MBBS (HK), FRCS (Edin), Tan-To Cheung MBBS (HK), FRCS (Edin), Sheung-Tat Fan MS, MD, PhD, FRCS (Edin & Glasg), FACS & Ronnie T. P. Poon MS, PhD, FRCS (Edin), FACS

  2. Department of Radiology, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China

    Jimmy Yuen MBBS (HK), FRCR, Helen Tung MBBS (HK), FRCR & Wai-Kuen Tso MBBS (HK), FRCR

  3. Cancer Institute, NSW, Australia

    Vincent Wai-To Lam MS, FRACS

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  1. Vincent Wai-To Lam MS, FRACS
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  2. Kelvin K. Ng MBBS (HK), PhD, FRCS (Edin)
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  8. Sheung-Tat Fan MS, MD, PhD, FRCS (Edin & Glasg), FACS
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Correspondence to Ronnie T. P. Poon MS, PhD, FRCS (Edin), FACS.

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Lam, V.WT., Ng, K.K., Chok, K.SH. et al. Incomplete Ablation After Radiofrequency Ablation of Hepatocellular Carcinoma: Analysis of Risk Factors and Prognostic Factors. Ann Surg Oncol 15, 782–790 (2008). https://doi.org/10.1245/s10434-007-9733-9

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  • DOI: https://doi.org/10.1245/s10434-007-9733-9

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