Efficacy and safety of radiofrequency ablation for hepatocellular carcinoma in the caudate lobe of the liver

• DOI: 10.1111/j.1872-034x.2012.01095.x
• Publication Date: 2012-09-04T02:45:08Z
• Authors: Youichi Nishigaki; Eiichi Tomita; Hideki Hayashi; Yusuke Suzuki; Soichi Iritani; Tomohiro Kato; Tetsuya Yamada
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

AimRadiofrequency ablation (RFA) is a promising alternative to hepatic resection for the treatment of hepatocellular carcinoma (HCC) located in the caudate lobe. We evaluated the therapeutic efficacy and safety ofRFAforHCClocated in the caudate lobe compared withHCClocated elsewhere in the liver.MethodsOverall, 555 consecutive patients treated byRFAfor a singleHCCtumor of less than 3 cm diameter, were enrolled in this study, including 20 patients withHCClocated in the caudate lobe. Among these 20 patients,HCCwas located in theSpiegel lobe in eight patients, in the paracaval portion in another 10 and in the caudate process in two. We evaluated differences in the local recurrence rate and the incidence of complications associated withRFAbetween the caudate and the non‐caudate groups.ResultsThe 4‐year cumulative local recurrence rate afterRFAin the caudate group and the non‐caudate group was 22.3% and 4.5%, respectively (P < 0.001). Multivariate analysis of factors affecting local recurrence demonstrated that tumor size and tumor location (caudate or non‐caudate) were independent significant factors. No postoperative complications were observed in the caudate group, whereas 15 patients (2.8%) in the non‐caudate group experienced complications related toRFA.ConclusionWe were able to safely treatHCClocated in the caudate lobe byRFA. However, there was a high incidence of local recurrence, presumably because of the heat sink effect of the inferior vena cava and the restricted puncture approach. We should pursue a revised method to reduce local recurrence.