Percutaneous radiofrequency ablation for hepatocellular carcinoma: Early termination versus standard termination of ablation procedure

摘要

Objective: To compare the effectiveness of early termination (ET) and standard termination (ST) of radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) using internally cooled electrodes. Methods: Eighty-three treatment naive patients with HCC with 101 index tumor underwent RFA. ET was defined as termination of ablation if after 6 minutes the power emission was < 10 seconds for three times per minute under maximal power. Standard termination was defined as termination of ablation according to manufactures' algorithms of 12 minutes' procedure. Primary end point was complete ablation of index tumor after 4 weeks of RFA. Results: Nineteen patients (22.9) underwent ET and 64 patients (77.1) underwent ST. The mean size of the index tumor was 2.2 + 0.9 cm. Patient had complete ablation of the index tumor at 92.0 for the ET and 88.2 for the ST (p = 0.593). Eight of 25 (32.0) for the ET and 18 of 73 (24.7) for the ST group had local tumor progression on last follow-up (p = 0.473). After a median follow-up of 23 weeks (range, 9-33 weeks), the 24 weeks cumulative probability of local tumor progression was not different between ET (46.2) and ST (25.6; p =; 0.387). Complete ablation at 4 weeks was the only independent factor associated with local tumor progression (adjusted hazard ratio 0.04, 95 confidence interval 0.01-0.16, p < 0.001). Conclusion: Using ET in RFA is as effective as the ST in.achieving complete ablation and local tumor progression.