Rationale and Objectives
To compare the efficacy and complications of ultrasound-guided percutaneous radiofrequency
ablation of hepatocellular carcinoma (HCC) in the hepatocaval confluence with those
of HCC in the non-hepatocaval confluence and to explore the risk factors that lead
to radiofrequency ablation failure and patient local tumor progression (LTP).
Materials and Methods
From January 2017 to January 2022, 86 patients with HCC in the hepatocaval confluence
who had radiofrequency ablation were included. A 1:1 propensity-matched group of patients
with HCC in the non-hepatocaval confluence with comparable clinical baseline traits,
such as tumor diameter and tumor number, served as the control group. The two groups'
complications, primary efficacy rate (PER), technical success rate (TSR), and prognosis
were estimated.
Results
After PSM, no significant difference of TSR (91.7% vs 95.8%, p = 0.491) and PER (95.8%
vs 97.2%, p = 1.000) and 1-, 3-, and 5-year LTP rate (12.5% vs 9.9%, 28.2% vs 27.7%,
40.8% vs 43.8%, p = 0.959) and 1-, 3-, and 5-year DFS rate (87.5% vs 87.5%, 62.3%
vs 54.2%, 18.1% vs 22.6%, p = 0.437) and 1-, 3-, and 5-year OS rate (94.3% vs 95.7%,
72.7% vs 69.6%, 20.9% vs 33.6%, p = 0.904) was detected between the two groups. The
tumor-to-IVC distance was an independent risk factor for radiofrequency ablation failure
in HCC patients in the hepatocaval confluence (OR = 0.611, p = 0.022). Besides, tumor
diameter was an independent risk factor for predicting LTP in patients with HCC in
the hepatocaval confluence (HR = 2.209, p = 0.046).
Conclusion
HCC in the hepatocaval confluence can be effectively treated with radiofrequency ablation.
To maximize treatment efficacy, the tumor-to-IVC distance and tumor diameter should
be assessed before the operation begins.
Abbreviations:
HCC (hepatocellular carcinoma), LTP (local tumor progression), TSR (technical success rate), PER (primary efficacy rate), ROC (receiver operating characteristic), IVC (inferior vena cava), AASLD (American Association for the Study of Liver Diseases), EASL (European Association for the Study of the Liver), RFA (radiofrequency ablation), ECOG (East Coast Oncology Group), PTA (prothrombin activity), TACE (transcatheter arterial chemoembolization), CT (computerized tomography), MRI (magnetic resonance imaging), SIR (Society of Interventional Radiology), OR (odds ratio), HR (hazard ratio), DFS (disease-free survival), OS (overall survival)Key Words
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Article info
Publication history
Published online: May 11, 2023
Accepted:
March 31,
2023
Received in revised form:
March 30,
2023
Received:
March 9,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Published by Elsevier Inc. on behalf of The Association of University Radiologists
