Laparoscopic radiofrequency ablation for hepatocellularcarcinoma

Aim:The optimal treatment for hepatocellular carcinoma(HCC)is either surgical resection or liver transplantation,but only one-third of the patients are suitable candidates for surgery.Laparoscopic radiofrequency ablation(RFA)in selected patients is a safe,feasible technique,which has proved to be superior to the percutaneous approach in patients with severe liver disease or in lesions in which the percutaneous approach is impossible.The aim of this study is to present our experience with laparoscopic RFA and demonstrate its safety as an alternative therapeutic procedure in selected patients with HCC.Methods:This is a retrospective study of patients with HCC who underwent laparoscopic RFA between March 2009 and December 2014.Results:Thirty-two patients with 37 tumors underwent laparoscopic RFA.Median tumor size was 2.24 cm(0.7-4.45 cm).Major complications occurred in 8 patients.Initial complete ablation was achieved in 94.6%(35/37)lesions and sustained complete ablation rate was 62.85%(22/35).Overall survival rates at 1-,2-,and 3-year were 89%,67.5%,and 40%,respectively.Conclusion:Laparoscopic RFA of HCC is safe and the long-term outcomes are similar to those achieved with liver resection.Further trials combining chemoembolization and RFA are needed to improve long-term outcomes and to limit local tumor progression.