Efficacy and safety of CT-guided percutaneous thermal ablation for hepatocellular carcinoma adjacent to the second porta hepatis

Abstract

<b>Purpose:</b> This study assessed the efficacy and safety of computed tomography (CT)-guided percutaneous thermal ablation for hepatocellular carcinoma adjacent to the second porta hepatis.<b>Methods:</b> From January 2011 to June 2018, 59 consecutive patients (51 men and 8 women aged 29-85 years) with 65 tumors (mean maximum tumor diameter: 20.5 ± 1.2 mm; range: 5-50 cm) adjacent to the second porta hepatis underwent percutaneous CT-guided thermal ablation. The complete ablation rate, local progression-free survival (LPFS), progression-free survival (PFS), prognostic factors for local progression, and safety of this technique were assessed.<b>Results:</b> No more than three sessions were performed to complete a patient's treatment. Technical success was achieved for all tumors. In the median follow-up of 18.5 months, local tumor progression occurred in 32.2% (19/59) of patients, while tumor progression occurred in 71.2% (42/59). The median LPFS was 37.4 months. The 1-, 2-, and 3-year LPFS rates were 86.2%, 66.5%, and 66.5%, respectively. The median PFS was 11.0 months. The 1-, 2-, and 3-year PFS rates were 47.9%, 27.0%, and 20.2%, respectively. The tumor size (<i>P</i> = .007) and distance between the tumor and inferior vena cava (<i>P</i> = 0.018) were the independent prognostic factors for local tumor progression.<b>Conclusion:</b> We showed that CT-guided percutaneous microwave ablation and radiofrequency ablation are effective and safe treatments for tumors adjacent to the second porta hepatis, particularly in patients with lesions less than 3 cm and a distance between the tumor and inferior vena cava of more than 5 mm.