Treatment of hepatocellular carcinoma in the caudate lobe: US-guided percutaneous radiofrequency ablation combined with ethanol ablation

AIM: To evaluate the technical feasibility and treatment results of ultrasound (US)-guided percutaneous radiofrequency ablation (RFA) combined with ethanol ablation (EA) for hepatocellular carcinoma (HCC) in the caudate lobe. MATERIALS AND METHODS: The institutional review board approved this retrospective study and the requirement for informed consent was waived. From October 2009 to June 2016, there were 49 patients with HCC in the caudate lobe underwent ablation. Among them, 14 patients (12 men and two women, mean age: 49.9 +/- 14.9 years) with 16 caudate lobe HCCs (mean size: 3 +/- 1.1 cm) who underwent US-guided RFA-EA were identified. These patients were compared with patients who underwent RFA alone (n = 17) and EA alone (n = 18). RESULTS: HCCs in the RFA-EA group were larger than those in the EA-alone group (3 +/- 1.1 versus 2.1 +/- 0.7 cm, p = 0.028). In the RFA-EA group, all the patients achieved treatment success (14/14) and entered follow-up. After a follow-up period of 17.1 +/- 10.6 months (range, 5-36 months), local tumour progression (LTP) was detected in four tumours. The 1-and 2-year LTP rates after RFA-EA were 18.8% and 27.8%, respectively. The 1-and 2-year disease-free survival (DFS) rates were 35.7% and 13.4%. Six patients died, with the 1-, 2-, and 3-year overall survival (OS) rates of 85.1%, 63.1%, and 21%, respectively. There were no significant differences in the LTP, DFS, and OS rates between the RFA-EA group and RFA-alone or EA groups (p = 0.363-0.733). CONCLUSION: US-guided percutaneous RFA-EA appears to be a feasible and effective treatment for HCC in the caudate lobe. (C) 2018 Published by Elsevier Ltd on behalf of The Royal College of Radiologists.