Clinical StudyPercutaneous Radiofrequency Ablation with Internally Cooled versus Internally Cooled Wet Electrodes for Small Subphrenic Hepatocellular Carcinomas
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Patient Population
Patients were retrospectively included if they had (i) a single HCC≤3 cm in diameter, (ii) HCC adjacent to the diaphragm (HCCs with margins located<1 cm from the diaphragm), (iii) no imaging evidence of vascular invasion by the tumor, and (iv) no evidence of extrahepatic disease. Patients were excluded if they had (i) multiple HCCs, (ii) the presence of vascular invasion, (iii) extrahepatic metastases, or (iv) coagulopathy (platelet count<50×103/μL; international normalized ratio>1.5). Our
Patient Characteristics
The characteristics of the patients in this study are summarized in Table 1. Of 165 patients, 122 tested positive for hepatitis B virus, 17 tested positive for hepatitis C virus, and 26 tested negative for both hepatitis B virus and hepatitis C virus. At the time of RF ablation, 148 patients had cirrhosis, 9 had chronic hepatitis, and 8 had neither cirrhosis nor chronic hepatitis. Tumor sizes ranged from 0.5–2.8 cm in the IC group and from 0.8–3 cm in the ICW group. There were no significant
Discussion
RF ablation of subphrenic HCCs remains an important therapeutic challenge because of the difficulties in targeting these tumors and creating sufficient safety margins. A comparison of clinical outcomes after percutaneous RF ablation in patients with nonsubphrenic and subphrenic HCCs showed that the latter tended to have decreased rates of technical success (98% vs 84%) and technical effectiveness (98% vs 90%) (19). Most importantly, the local tumor progression rate after RF ablation was
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None of the authors have identified a conflict of interest.