Ultrasound-guided percutaneous thermal ablation for treatment of hepatocellular carcinoma

Objective To investigate the efficacy of thermal ablation for treatment of hepatocellular carcinoma (HCC). Methods A total of 190 nodules of HCC in 97 patients were treated with microwave or radiofrequency ablation. Results Complete ablation was achieved in 93% of the nodules. The complete ablation rates in tumors ≤2.0 cm, 2.1-3.9 cm and ≥4.0 cm in diameter were 93%, 94% and 86%, respectively. Local recurrence was found in 10% of the nodules and the recurrent rates tumors ≤2.0 cm, 2.1-3.9 cm and ≥4.0 cm in diameter were 3%, 10% and 32%, respectively. The 1-, 2- and 3-year distant recurrence-free survival rates were 47%, 35% and 31%, respectively. The 1-, 2- and 3-year cumulative survival rates were 76%, 59% and 50%, respectively. Conclusions Thermal ablation by means of microwave and radiofrequency energy application is an effective and safe therapeutic modality for HCC. Large tumors can be completely ablated but it has a significantly higher risk of local recurrence.