Effectiveness of radiofrequency ablation for hepatocellular carcinomas larger than 3 cm in diameter

Hypothesis: Radiofrequency ablation is a safe and effective treatment for hepatocellular carcinomas 3.1 to 8.0 cm in diameter. Design: Case series with prospective data collection. Setting: Tertiary referral center. Patients: Eighty-six patients with hepatocellular carcinoma treated with radiofrequency ablation from May 1, 2001, to December 31, 2002, were placed into categories of those with tumors 3 cm or smaller (group 1, n= 51) and those with tumors 3.1 to 8.0 cm (group 2, n=35) in diameter. Interventions: Radiofrequency ablation was performed with a single or cluster cool-tip electrode. The choice of treatment route was based on tumor size and position. Main Outcome Measures: Complication, treatment mortality, and complete ablation rates. Results: Radiofrequency ablation was performed percutaneously in 26 patients in group 1 and 9 patients in group 2, with laparoscopy in 2 patients in group 1 and 1 patient in group 2, and with open operation in 23 patients in group 1 and 25 patients in group 2. The complication rates were 12% and 17% in group 1 and group 2, respectively (P=.48); treatment mortality rates were 0% and 3%, respectively (P=.41). Complete ablation rates after a single session of ablation assessed by means of computed tomography 1 month after treatment were 94% and 91% in group 1 and group 2, respectively (P=.68). Conclusion: Radiofrequency ablation is a safe and effective treatment for patients with hepatocellular carcinomas 3.1 to 8.0 cm in diameter.