Ultrasound-guided Radiofrequency Ablation for Early Hepatocellular Carcinoma
AKC Cheng, M Cheung, EYL Chu
Hong Kong J Radiol 2017;20:220-6
DOI: 10.12809/hkjr1715377
Objectives: To review the outcome and procedure-related complications of patients who underwent ultrasound-guided percutaneous radiofrequency ablation (RFA) for early hepatocellular carcinoma (HCC).
Methods: Medical records of patients who underwent RFA for stage I or IIa solitary HCC between January 2008 and July 2012 were reviewed.
Results: 17 men and 5 women aged 50 to 95 (mean, 66.3) years were included. The mean time from diagnosis to RFA was 1.8 months. At a mean follow-up of 1.7 months, 20 of 22 patients had complete ablation and no scar recurrence. At a mean follow-up of >8 months, 16 of 22 patients had no scar recurrence. At a mean follow-up of 36 months, 14 of 22 patients had recurrence, six had no recurrence, and two had died. The mean overall survival was 33.0 months. The overall survival at years 1, 2, and 3 were 100%, 86.4%, and 81.8%, respectively. The mean disease-free survival was 19.0 months. The disease-free survival at years 1, 2, and 3 were 54.5%, 44.4%, and 33.3%, respectively. The mean disease-free survival was longer in patients with a smaller tumour (≤1.8 cm) than those with a larger tumour (>1.8 cm) [27.1 vs. 10.9 months, p = 0.01]. None had procedure-related mortality or major complications.
Conclusion: Ultrasound-guided percutaneous RFA is a safe and effective primary treatment for early solitary HCC. Larger tumour is associated with a shorter disease-free survival; frequent follow-up is important.
Authors’ affiliations:
AKC Cheng, M Cheung, EYL Chu: Department of Radiology, Queen Mary Hospital, Pokfulam, Hong Kong
中文摘要
早期肝癌的超聲引導射頻消融治療
鄭嘉俊、張皓筠、朱賢麟
目的：回顧接受超聲引導經皮射頻消融（RFA）治療早期肝癌（HCC）的患者的療效和手術相關併發症。
方法：回顧2008年1月至2012年7月期間接受RFA治療I期或IIa期單發HCC患者的病歷。
結果：包括17男和5女，年齡50至95歲（平均66.3歲）。從診斷到RFA的平均時間為1.8個月。在平 均隨訪1.7個月後，22例中有20例完全消融及無疤痕復發。在平均隨訪>8個月後，22例中有16例無疤痕復發。在平均隨訪36個月後，22例中有14例復發、6例無復發及2例死亡。平均總生存期為33.0個 月。1年、2年和3年的總體生存率依次為100%、86.4%和81.8%。平均無病生存期為19.0個月。1年、2 年和3年無病生存率依次為54.5%、44.4%和33.3%。腫瘤較小（≤1.8 cm）比腫瘤較大（>1.8 cm）的患 者的平均無病生存期更長（27.1對10.9個月，p = 0.0）。無患者出現手術相關死亡或嚴重併發症。
結論：超聲引導經皮RFA能安全有效治療早期單發HCC。較大的腫瘤與較短的無病生存率相關聯；密切隨訪很重要。