Percutaneous Radiofrequency Ablation Treatment of Hepatocellular Carcinoma in Caudate Lobe Using Expandable Electrodes

Somrach  Thamtorawat; Torpong  Claimon; Satit  Rojwatcharapibarn; Pradesh  Ghirnire; Trongtum  Tongdee; Jirawadee  Yodying; Walailak  	 Chaiyasoot

doi:10.33192/Smj.2021.70

Authors

Somrach Thamtorawat Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Torpong Claimon Department of Radiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Satit Rojwatcharapibarn Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Pradesh Ghirnire Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Trongtum Tongdee Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Jirawadee Yodying Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Walailak Chaiyasoot Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.33192/Smj.2021.70

Keywords:

Caudate lobe, Expandable electrodes, Hepatocellular carcinoma, Radiofrequency ablation

Abstract

Objective: To evaluate the outcome of radiofrequency (RF) ablation using expandable electrodes in the treatment of hepatocellular carcinoma (HCC) located in the caudate lobe.
Materials and Methods: Between January 2011 and April 2017, 29 consecutive patients with HCC at the caudate lobe were treated with RF ablation using expandable electrodes. The electrodes were placed on the targeted tumor under combined ultrasound and computed tomography (CT) guidance for each tumor in all the patients. Out of the 29 cases, 19 (65.5%) were accessed via the left hepatic lobe. The technical success, primary efficacy, local tumor progression, secondary efficacy, overall survival, and complications were evaluated. Univariate analysis was performed of the various prognostic factors for technical success, primary efficacy, and local tumor progression.
Results: The technical success rate was 86.2%, primary efficacy was 89.7%, and secondary efficacy was 82.8%. The local tumor progression (LTP) rate was 12.3% at one year and 31.5% at two years. The median time of LTP was 6.9 months. The overall survival rate was 85.8% at one year and 57.1% at two years. Ten patients died during the follow-up period (mean 22.5 months; with a range of 3.6–53.2 months). A minor complication of asymptomatic biloma was found in one patient (3.5%). Small-sized tumors (≤2 cm) and Spiegel’s lobe location had significantly better treatment outcomes (p = 0.007 and 0.045, respectively).
Conclusion: Radiofrequency ablation using expandable electrodes is feasible and safe in treating HCCs located in the caudate lobe, especially for small-sized tumors (≤2 cm).

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