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Recurrent Hepatocellular Carcinoma: Percutaneous Radiofrequency Ablation after Hepatectomy¹

¹ From the Department of Radiology and Center for Imaging Science (D.C., H.K.L., M.J.K., S.H.L., S.H.K., W.J.L., J.H.L.) and the Department of Surgery (J.W.J., Y.I.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135–710, Korea. Received September 17, 2002; revision requested November 26; final revision received April 27, 2003; accepted June 16. Address correspondence to H.K.L. (e-mail: hklim@smc.samsung.co.kr).

PURPOSE: To evaluate the therapeutic efficacy and safety of percutaneous radiofrequency (RF) ablation for recurrent hepatocellular carcinoma (HCC) in the liver after hepatectomy.

MATERIALS AND METHODS: Forty-five patients with 53 recurrent HCC tumors in the liver underwent percutaneous RF ablation with ultrasonographic guidance. All patients had a history of hepatic resection for HCC. The mean diameter of recurrent tumors was 2.1 cm (range, 0.8–4.0 cm). All patients were followed up for at least 10 months after ablation (range, 10–40 months; mean, 23 months). Therapeutic efficacy and complications were evaluated with multiphase helical computed tomography (CT) at regular follow-up visits. Overall and disease-free survival rates were calculated.

RESULTS: At follow-up CT after initial RF ablation, 11 (21%) of 53 ablated HCC tumor sites showed residual tumor or local tumor progression. After additional RF ablation, complete ablation of 46 (87%) of 53 tumors was attained. Also at initial follow-up CT, before either additional RF ablation or other treatment was performed, 21 (47%) of 45 patients were found to have 41 new HCC tumors at other liver sites. Of these, nine tumors in eight patients were treatable with a second application of RF ablation. Overall survival rates at 1, 2, and 3 years were 82%, 72%, and 54%, respectively. No deaths or complications requiring further treatment occurred as a result of RF ablation.

CONCLUSION: Percutaneous RF ablation is an effective and safe method for treating recurrent HCC in the liver after hepatectomy, with a good overall patient survival rate.

© RSNA, 2003

Index terms: Liver, interventional procedures • Liver, surgery, 761.1267, 761.45 • Liver neoplasms, therapy, 761.323 • Radiofrequency (RF) ablation, 761.1269

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