Enhanced Radiofrequency Ablation for Recurrent Hepatocellular Carcinoma Post-Transarterial Chemoembolization: A Prospective Study Utilizing Twin Internally Cooled-Perfusion Electrodes.

Abstract

Background: Radiofrequency ablation (RFA) is widely employed for managing recurrent hepatocellular carcinoma (HCC) following transarterial chemoembolization (TACE). However, local tumor progression (LTP) after treatment remains a significant challenge. This study evaluates the efficacy of saline-perfused bipolar RFA using twin internally cooled-perfusion (TICP) electrodes in managing recurrent HCC post-TACE.

Methods: Between September 2017 and January 2019, 100 patients with 105 nodules (mean diameter: 1.6 ± 0.5 cm) were prospectively enrolled. Bipolar RFA with TICP electrodes was performed under ultrasound-CT/MR fusion guidance. The primary outcome was the 2-year cumulative incidence of LTP.

Results: The technical success and technique efficacy rates were 100% and 97%, respectively. During a median follow-up period of 34.0 months (range: 3-41 months), the estimated LTP rates were 13.3% at 1 year and 17.7% at 2 years. Progression-free survival rates were 37.8% and 27.7% at 1 and 2 years, respectively.

Conclusions: Saline-perfused bipolar RFA using TICP electrodes demonstrates promising results for recurrent HCC after TACE, achieving high technical success and effective local tumor control rates.