Efficacy analysis of radiofrequency ablation of hepatocellular carcinoma guided by ultrasound combined with preoperative three-dimensional reconstruction

Objective To investigate the efficacy of radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) guided by ultrasound combined with preoperative three-dimensional reconstruction.Methods The clinical data of 96 patients with HCC who were admitted to the Affiliated Tumor Hospital of Guangzhou Medical University from January 2009 to December 2012 were retrospectively analyzed.All the 96 patients were with solitary tumor,and the diameters of the tumor ranged between 3 and 5 cm.Forty-three patients received RFA of HCC guided by ultrasound combined with preoperative three-dimensional reconstruction and were in the RFA group ; 53 patients with small HCC who received surgical resection were in the resection group.The efficacy of the treatment in the 2 groups was compared.Patients were followed up by out-patient examination or phone call till March 31,2014.The count data were analyzed using the chi-square test or Fisher exact probability,the survival curve was drawn by Kaplan-Meier method,and the survival rates of the 2 groups were compared using the Log-rank test.Results The complete ablation rate of the RFA group was 95.3％ (41/43).Of the 53 patients in the resection group,32 received wedge resection,17 received local resection of the tumor and 4 received anatomical lobectomy.The incidences of severe complications in the RFA group and the resection group were 4.7％ (2/43) and 24.5％ (13/53),with no significant differences between the 2 groups (x2 =2.385,P ＜ 0.05).One patient in the RFA group and 3 in the resection group missed the follow-up.Needle tract implantation was not observed in the RFA group.The 1-,2-,3-year tumor recurrence rates were 21.8％,44.9％ and 50.4％ in the RFA group,and 26.4％,36.8％ and 49.4％ in the resection group.There was no significant difference in the 3-year tumor recurrence rate between the 2 groups (x2 =0.000,P ＞ 0.05).The 1-,2-,3-year overall survival rates were 90.6％,76.1％ and 57.9％ in the RFA group,and 88.5％,73.4％ and 65.3％ in the resection group.There was no significant difference in the 3-year overall survival rate between the 2 groups (x2 =0.000,P ＞ 0.05).Conclusions For small HCC with diameter ranged between 3 and 5 cm,RFA guided by ultrasound combined with preoperative three-dimensional reconstruction could improve the success rate of complete ablation rate with less complications,and the efficacy is similar to that of surgical resection. Key words: Liver neoplasms ;  Three-dimensional reconstruction ;  B ultrasound ;  Efficacy