Radiofrequency Ablation of Recurrent Hepatocellular Carcinoma After Hepatectomy: Therapeutic Efficacy on Early- and Late-Phase Recurrence
Wei Yang1,
Min Hua Chen1,
Shan Shan Yin1,
Kun Yan1,
Wen Gao1,
Yan Bin Wang1,
Ling Huo1,
Xiao Peng Zhang2 and
Bao Cai Xing3
1 Department of Ultrasound, Peking University School of Oncology, 52 Fu-cheng
Rd., Hai-dian District, Beijing 100036, People's Republic of China.
2 Department of Radiology, Peking University School of Oncology, Beijing 100036,
People's Republic of China.
3 Department of Surgery, Peking University School of Oncology, Beijing 100036,
People's Republic of China.
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Fig. 1A —54-year-old man in whom intrahepatic hepatocellular carcinoma (HCC)
recurred 3 months after partial resection of right hepatic lobe
(early-recurrence group). Before radiofrequency ablation,  -fetoprotein
level rose to 788.9 ng/mL. Transverse contrast-enhanced CT scan shows
spherical recurrent tumor in segment VII (arrow).
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Fig. 1B —54-year-old man in whom intrahepatic hepatocellular carcinoma (HCC)
recurred 3 months after partial resection of right hepatic lobe
(early-recurrence group). Before radiofrequency ablation, -fetoprotein
level rose to 788.9 ng/mL. Intercostal sonogram shows this tumor being treated
by sonography-guided radiofrequency ablation.
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Fig. 1D —54-year-old man in whom intrahepatic hepatocellular carcinoma (HCC)
recurred 3 months after partial resection of right hepatic lobe
(early-recurrence group). Before radiofrequency ablation, -fetoprotein
level rose to 788.9 ng/mL. CT scan obtained 5 months after repeated
radiofrequency ablation shows nodular enhanced area in outer part of ablated
area (arrow), indicating local recurrence. Multiple distant
recurrences and portal vein thrombosis (arrowhead) developed at same
time. This patient survived 13 months before dying of tumor spread and
metastasis.
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Fig. 2A —64-year-old man in whom intrahepatic hepatocellular carcinoma
recurred 69 months after partial resection of left hepatic lobe
(late-recurrence group). Transverse contrast-enhanced CT scan shows spherical
recurrent tumor (arrow) in right lobe of liver.
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Fig. 2B —64-year-old man in whom intrahepatic hepatocellular carcinoma
recurred 69 months after partial resection of left hepatic lobe
(late-recurrence group). Intercostal sonogram shows tumor being treated by
sonography-guided radiofrequency ablation.
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Fig. 2C —64-year-old man in whom intrahepatic hepatocellular carcinoma
recurred 69 months after partial resection of left hepatic lobe
(late-recurrence group). CT scan obtained 1 month after radiofrequency
ablation shows low-attenuation area of coagulation (arrow) with sharp
margin and no enhancement.
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Fig. 2D —64-year-old man in whom intrahepatic hepatocellular carcinoma
recurred 69 months after partial resection of left hepatic lobe
(late-recurrence group). CT scan obtained 17 months after radiofrequency
ablation shows obvious decrease in size of unenhanced area of ablation
(arrow). This patient was still alive after more than 2 years, with
completely necrotic tumor.
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Fig. 3A —67-year-old man in whom intrahepatic hepatocellular carcinoma
recurred 55 months after partial resection of right hepatic lobe
(late-recurrence group). Before radiofrequency ablation, level of
-fetoprotein reached 180 ng/mL. Transverse contrast-enhanced CT scans
show no nodular enhancement in arterial phase but low-attenuation nodule
(arrow) in portal phase. Nodule was verified to be malignant by
needle biopsy.
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Fig. 3B —67-year-old man in whom intrahepatic hepatocellular carcinoma
recurred 55 months after partial resection of right hepatic lobe
(late-recurrence group). Before radiofrequency ablation, level of
-fetoprotein reached 180 ng/mL. Intercostal sonograms show 2.8-cm tumor
being treated by sonography-guided radiofrequency ablation.
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Fig. 3D —67-year-old man in whom intrahepatic hepatocellular carcinoma
recurred 55 months after partial resection of right hepatic lobe
(late-recurrence group). Before radiofrequency ablation, level of
-fetoprotein reached 180 ng/mL. CT scan obtained 18 months after
radiofrequency ablation shows nodular enhanced area (arrow) in right
exterior part of ablated area, indicating local recurrence. This recurrence
was treated by repeated radiofrequency ablation.
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Fig. 3E —67-year-old man in whom intrahepatic hepatocellular carcinoma
recurred 55 months after partial resection of right hepatic lobe
(late-recurrence group). Before radiofrequency ablation, level of
-fetoprotein reached 180 ng/mL. CT scan obtained 1 month after repeated
radiofrequency ablation shows that ablated lesion had clear margin and no
enhancement. This patient was still alive after more than 2 years, with
complete tumor necrosis.
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Fig. 4 —Overall survival curves after radiofrequency ablation of
early-recurrence group (n = 20), late-recurrence group (n =
21), and control group (n = 116). Gray line = late recurrence group;
black line = early recurrence group; dashed line = control group.
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Fig. 5 —Disease-free survival curves after radiofrequency ablation of
early-recurrence group (n = 20), late-recurrence group (n =
21), and control group (n = 116). Gray line = late recurrence group;
black line = early recurrence group; dashed line = control group.
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Copyright © 2006 by the American Roentgen Ray Society.
