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Therapeutic Efficacy and Safety of Percutaneous Radiofrequency Ablation of Hepatocellular Carcinoma Abutting the Gastrointestinal Tract

¹ Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-ku, Seoul 135-710, South Korea.
² Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.

OBJECTIVE. The purpose of this study was to evaluate the therapeutic efficacy and safety of percutaneous radiofrequency ablation in the treatment of hepatocellular carcinomas abutting the gastrointestinal tract.

MATERIALS AND METHODS. Forty-one patients with hepatocellular carcinomas abutting the gastrointestinal tract underwent sonographically guided percutaneous radiofrequency ablation. Forty-one tumors (1.2–4.3 cm in maximum diameter) had parts 5 mm or greater (or at least one quarter of their circumferences) abutting the stomach in 23 patients and the colon in 18 patients. Thirty tumors were ablated with internally cooled electrodes and 11 with multitined expandable electrodes. All patients were followed up for at least 1 year after ablation. Therapeutic efficacy and safety were evaluated with follow-up sonography and multiphase helical CT.

RESULTS. At 1-month follow-up CT, three (7%) of the 41 tumors showed residual unablated tumor in the ablation zone. Of the remaining 38 hepatocellular carcinomas (93%) with no evidence of residual unablated tumor, four (11%) showed local tumor progression in the ablation zones on subsequent follow-up CT. We observed one major complication—a small perihepatic abscess—that needed specific treatment.

CONCLUSION. Percutaneous radiofrequency ablation is an effective and safe technique for treating hepatocellular carcinomas abutting the gastrointestinal tract.

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