Percutaneous radiofrequency ablation for pulmonary metastases from hepatocellular carcinoma: Results of a multicenter study in Japan

Takao Hiraki, Koichiro Yamakado, Osamu Ikeda, Toshiyuki Matsuoka, Toshio Kaminou, Takuji Yamagami, Hideo Gobara, Hidefumi Mimura, Koichi Kawanaka, Kan Takeda, Yasuyuki Yamashita, Yuichi Inoue, Toshihide Ogawa, Tsunehiko Nishimura, Susumu Kanazawa

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Abstract

Purpose: To retrospectively evaluate technical success, effectiveness, complications, patient survival, and prognostic factors with percutaneous radiofrequency (RF) ablation for pulmonary metastases resulting from hepatocellular carcinoma (HCC). Materials and Methods: Thirty-two patients from six institutions were included, with a total of 83 pulmonary metastases treated in 65 sessions. RF ablation was always performed percutaneously with computed tomography (CT) guidance. Primary endpoints were technical success and technique effectiveness. Technique effectiveness was evaluated based on sequential follow-up CT images. Secondary study endpoints were complications, patient survival, and determination of prognostic factors. Complications were classified as major or minor. Prognostic factors were determined by analyzing multiple variables with the log-rank test. Results: Technical success rate was 100%. Primary technique effectiveness rates were 92% each at 1, 2, and 3 years. Major and minor complications occurred after 16 (25%) and 23 (35%) of the 65 sessions, respectively. The median follow-up period was 20.5 months. Overall survival rates were 87% at 1 year and 57% each at 2 and 3 years (median and mean survival times, 37.7 mo and 43.2 mo, respectively). Significantly better survival rates were obtained in cases of (i) no viable intrahepatic recurrence (P < .001), (ii) Child-Pugh class A disease (P < .001), (iii) absence of liver cirrhosis (P < .001), (iv) absence of hepatitis C virus infection (P = .006), and (v) α-fetoprotein level of 10 ng/mL or lower (P = .007) at the time of RF ablation. Conclusions: RF ablation appears effective, with an acceptable safety profile, in selected patients with pulmonary metastases resulting from HCC.

Original languageEnglish
Pages (from-to)741-748
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume22
Issue number6
DOIs
Publication statusPublished - Jun 2011

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Hiraki, T., Yamakado, K., Ikeda, O., Matsuoka, T., Kaminou, T., Yamagami, T., Gobara, H., Mimura, H., Kawanaka, K., Takeda, K., Yamashita, Y., Inoue, Y., Ogawa, T., Nishimura, T., & Kanazawa, S. (2011). Percutaneous radiofrequency ablation for pulmonary metastases from hepatocellular carcinoma: Results of a multicenter study in Japan. Journal of Vascular and Interventional Radiology, 22(6), 741-748. https://doi.org/10.1016/j.jvir.2011.02.030