Laparoscopic radiofrequency ablation of subcapsular hepatocellular carcinomas: risk factors related to a technical failure

Surg Endosc. 2022 Jan;36(1):504-514. doi: 10.1007/s00464-021-08310-7. Epub 2021 Feb 1.

Abstract

Background: This study aimed to evaluate the risk factors related to a technical failure after laparoscopic radiofrequency ablation (RFA) for subcapsular hepatocellular carcinomas (HCCs).

Materials and methods: A total of 110 patients with 114 HCCs who underwent laparoscopic RFA for HCCs (new HCC [n = 85] and local tumor progression [LTP] [n = 29]) between January 2013 and December 2018 were included. We evaluated the incidence of technical failure on immediate post-RFA CT images. Risk factors for a technical failure after laparoscopic RFA were assessed using univariable logistic regression analyses. The cumulative LTP rate was estimated using the Kaplan-Meier method.

Results: Technical failure was noted in 3.5% (4/114) of the tumors. All four tumors that showed a technical failure were cases of LTP from previous treatment and were invisible on laparoscopy. On univariate analysis, LTP lesion, invisibility of the index tumor on laparoscopy, and peri-hepatic vein location of the tumor were identified as risk factors for a technical failure. The cumulative LTP rates at 1, 3, and 5 years were estimated to be 2.8%, 4.8%, and 4.8%, respectively.

Conclusions: LTP lesion, invisibility of the index tumor on laparoscopy, and peri-hepatic vein location of the tumor were identified as the risk factors for a technical failure after laparoscopic RFA.

Keywords: Hepatocellular carcinoma; Laparoscopy; Liver; Local; Neoplasm recurrence; Radiofrequency ablation.

MeSH terms

  • Carcinoma, Hepatocellular* / pathology
  • Carcinoma, Hepatocellular* / surgery
  • Catheter Ablation* / adverse effects
  • Catheter Ablation* / methods
  • Humans
  • Laparoscopy* / adverse effects
  • Liver Neoplasms* / pathology
  • Liver Neoplasms* / surgery
  • Radiofrequency Ablation* / adverse effects
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome