Clinical investigation of CT-guided radiofrequency ablation for liver cancer in hepatic dome area

Objective: To investigate the technical procedure, clinical efficacy and safety of extrathoracic and transhepatic CT-guided radiofrequency ablation (CT-RFA) for liver cancer in hepatic dome area. Methods: A retrospective analysis was conducted in 50 patients who were diagnosed of primary liver cancer or metastatic liver cancer and received CT-RFA between September 2003 and October 2012. The total number of the malignant lesions in the hepatic dome area were 59. The detailed technical procedure, clinical efficacy and the safety as well as the factors related to local recurrence-free survival were anaylized and summarized. Results: The pathway for needle puncture of RT-RFA in treatment of the malignant lesions in the hepatic dome area was established by using a new “cube” model. The rates of technical success in RFA and complete necrosis were 94.92% (56/59) and 84.75% (50/59), respectively. The median local recurrence-free survival time of patients with completely necrotic lesions was 12.05 months, which for primary liver cancer and metastatic liver cancer were 14.23 and 8.07 months, respectively (P = 0.037). Three patients developed severe complications after RFA, and recovered after supportive treatment. The multivariable analysis revealed that the tumor size was an independent factor related to the local recurrence-free survival (P = 0.028). Conclusion: CT-RFA for the treatment of malignant lesions in the hepatic dome area is safe and effective. The tumor size is an independent risk factor related to the local recurrence-free survival. DOI:10.3781/j.issn.1000-7431.2014.01.010