Title: Radiofrequency Ablation of Hepatocellular Carcinoma Located in the Liver Dome Under Intermittent CT Fluoroscopy Guidance
Abstract: Purpose: To evaluate the clinical effectiveness of an intermittent computed tomography (CT) fluoroscopy-guided radiofrequency (RF) ablation of hepatocellular carcinoma located in the liver dome. Materials and Methods: Between 2005 and 2010 23 patients with hepatocellular carcinoma (HCC) nodules located in the liver dome underwent an intermittent CT fluoroscopy-guided RF ablation. The primary endpoint was the local tumor progression. Procedure-related complications occurred in 3 of 23 patients. To evaluate the prognostic factors for the local tumor progression, univariate and multivariate analyses were performed using the Cox proportional hazards model. The chisquared test was performed to evaluate the association of access route and procedure-related complication. The study was approved by the Institutional Review Board of our hospital. Results: The Tumor sizes ranged between 1.0 and 2.9 cm. An initial complete ablation was achieved in all patients. The median follow-up period was 31 months and the major complication rate was 4.3%. The cumulative rate of local tumor progression at 3 years was 20%. The univariate analysis revealed that only serum total bilirubin level (p = 0.048) and prior chemoembolization were statistically significant (p = 0.044), but there was no independently significant prognostic factor on multivariate analysis. Procedure-related complications occurred in 3 of 23 patients. Conclusion: For HCC located in the liver dome an intermittent CT fluoroscopyguided RF ablation could be performed safely and effectively. Index terms