Artificial ascites assisted ultrasound guided percutaneous radiofrequency ablation for hepatocellular carcinoma: analysis of survival and prognostic factors

Objective To evaluate the efficacy and safety of artificial ascites assisted percutaneous radiofrequency ablation in the treatment of hepatocellular carcinoma(HCC), and analyze its prognostic factors. Methods Fifty-three patients with HCC underwent ultrasound guided percutaneous injecting artificial ascites included in this retrospective study. Five patients had failed to introduce artificial ascites. Forty-eight patients achieved the aim, and then ultrasound guided radiofrequency ablation was performed. The curative effect and complications were observed, the intrahepatic tumor recurrence, survival condition and its prognostic factors were studied. Results Forty-eight patients achieved this process, and the success rate was 90.56%(48/53). All the 48 patients completed the ablation process and the complete ablation rate was 97.92%(47/48) for the first time. The cumulative intrahepatic disease-free survival rates were 45.6%, 15.3% and 6.4%, at 1, 2 and 3 years, respectively, for which the only significant risk factor was tumor type(primary or recurrence)(P=0.021). The cumulative overall survival rates were 88.2%, 62.0%, 44.9%, 32.4% and 29.2% at 1, 2, 3, 4 and 5 years, respectively. Patients with age>65 years (P=0.026) and tumor diameter>3 cm (P=0.002) revealed poor survival results. Three of 48 patients had reactive effusion in right pleural, one had low fever. There were no bleeding, gastrointestinal perforation and intraperitoneal tumor seeding. And no artificial ascites and ablation related death were observed. Conclusions Artificial ascites assisted ultrasound guided percutaneous RFA for HCC is safe and effective, and obtains satisfactory intrahepatic disease-free survival and long-term survival rate. And this technology is worth to study and promotion. Key words: Ultrasonography; Artificial ascites; Carcinoma, hepatocellular; Radiofrequency ablation; Prognostic