Laparoscopic Radiofrequency Ablation in Patients with Small Hepatocellular Carcinoma Awaiting Orthotopic Liver Transplantation

Primary hepatocellular carcinoma (HCC) is the cancer of primary hepatocyte or primary liver cell and is one of the most common cancers worldwide. HCC is an aggressive cancer often leading to death within 6 months of diagnosis in symptomatic individuals. It is potentially curable by surgical resection, but surgery is the treatment of choice only for a small fraction of patients with localized disease. Treatments other than surgery include infusional chemotherapy, hepatic artery ligation or embolization, percutaneous ethanol injection (PEI), radiofrequency ablation (RFA), cryotherapy, and radiolabeled antibodies. These have shown to be effective in patients with dysplastic nodules awaiting a liver transplantation, and increase the survival in these patients. In our study we instituted minimally invasive therapy radiofrequency ablation of small HCC to look for survival and recurrence in these patients. We looked for sensitivity and specificity of imaging modalities to detect HCC and evaluated the efficacy of RFA in treating patients with HCC awaiting liver transplantation. This is a retrospective case series analysis of 76 patients with small HCC defined as one tumor less than 5 cm or three or more tumors less than 3 cm in size, treated with RFA and awaiting orthotopic liver transplantation from February 2001 to May 2005. The overall patient survival at 6 months and 1-year post-RFA was found to be 85% and 59%. The overall recurrence-free survival at year1 was evaluated to be 42%. The sensitivity and specificity of imaging procedures (eg. CT, MRI) were found to be 43% and 83% respectively.Master of Public Healt