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Radiofrequency Ablation Is Safe for Liver Cancer Lesions Close to the Diaphragm: Presented at RSNA

By Ed Susman

CHICAGO, IL -- November 30, 2007 -- Researchers said that radiofrequency ablation of liver cancer that is close to or abutting the diaphragm are still viable targets that can be safely treated, researchers reported here at the 93rd Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA).

In a retrospective study, Tae Wook Kang, MD, Radiologist, Samsung Medical Center at Sungkyunkwan University School of Medicine, Seoul, Korea, and colleagues identified patients who underwent radiofrequency ablation at the experience at their centre between 2000 and 2006.

Of 667 patients, 39 cases had a tumour was within 5 mm of the diaphragm; these patients were matched with 41 similar patients whose lesions were not located near the diaphragm.

"If the index tumour abuts the diaphragm, the interventional radiologist must balance two conflicting factors: complete ablation and safe ablation," Dr. Kang said in a presentation on November 29.

The patients in the study were about 60 years of age and about two thirds of the patients in both groups were men. The tumours ranged in size from about 1.75 to 3 cm in diameter.

One patient in the abutting group experience haemothorax and one case of had pleural effusion subsequent to the percutaneous radiofrequency ablation procedure. These adverse events were not seen in the nonabutting patients. Transient lung injury occurred in seven patients in the abutting group and in none of the patients in the nonabutting group.

The technical success rate of the procedure was 84% in tumours that abutted the diaphragm compared with 98% for tumours that did not abut the diaphragm. About 29% of patients in the abutting group experience local tumour progression compared with 6% of the patients in the nonabutting group.

"Percutaneous radiofrequency ablation for hepatocellular carcinoma abutting the diaphragm is a safe procedure without major complications," Dr. Kang concluded from the study. "However, it is less effective with regard to technical success and local tumour control [compared with tumours that are further than 5 mm from the diaphragm]."

He said his study results are limited due to its retrospective design. The researchers did not consider the variability in the experience of the three interventional radiologists involved in the procedures.


[Presentation title: Percutaneous Radiofrequency Ablation for Hepatocellular Carcinoma Abutting the Diaphragm: Assessment of Safety and Therapeutic Efficacy. SSQ08-03]

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