Role of surgical radiofrequency ablation in treatment of hepatocellular carcinoma whit underlying cirrhosis

Objective: The aim of this paper is to evaluate retrospectively the results of radiofrequency ablation with surgical access, in term of overall and disease free survival, in patients affected by hepatocelluar carcinoma with underlying cirrhosis. Methods: Fifieen patient underwent radiofrequency ablation with surgical access in the Digestive Surgery Unit of the University of Florence between April2002 and November 2008. Three patients had laparoscopic access, and twelve laparotomic access. All patients were evaluated not eligible for liver resection because of low residual functional reserve. Nine patients had single nodules, while six had multinodular disease. Mean diameter of nodules was 3.2 cm (range 0.8-5.2 cm). A cool tip needle (radionix, valleylab) was used for radiofrequency ablation, using single needle for nodules <3 cm and cluster needle for nodules >3cm. Results: Overall survival and disease free survival was 93.3 % and 86.2% respectively at 12 months and 368% and 18.8% at 30 months. Mean survival was 14.13 months (range 4.07-29.9 months). Multinodular disease and nodules diameter did not influence survival (p>0.5). Conclusion: Radiofrequency ablation is an important therapeutic option for patients affected by hepatocellular carcinoma non suitable for liver resection, with good results in term of overall and disease-free survival, with very low percentage of morbidity and mortality. Surgical access has to be performed only for patients not elegible for liver resection.