Influence of Two Needle Placements on the Local Efficacy of Radiofrequency Ablation for Hepatic Carcinoma

  Objective  To explore the local efficacy of two different ways of needle placement in the treatment of hepatic carcinoma with radiofrequency ablation.

  Methods  Data of patients with hepatic carcinoma treated with radiofrequency ablation from January 2014 to December 2018 in Peking University Cancer Hospital were retrospectively analyzed. Based on the way of needle placement, the patients were divided into parallel placement group and simple placement group. Contrast-enhanced CT or MRI was performed to measure the coagulation range (long diameter, short diameter and thick diameter) and the tumor inactivation one month after the treatment of radiofrequency ablation. The local tumor progression rate was calculated at the follow-ups.

  Results  A total of 281 patients (370 lesions) who met the inclusion and exclusion criteria were included in this study. Of whom, 111 cases (111 lesions) were finally included and analyzed after correction by the method of propensity score matching. 37 cases (37 lesions) were in the parallel placement group and 74 cases (74 lesions) were in the simple placement group. The thickness of the parallel placement group was significantly larger than that of the simple placement group (mean difference=0.39, 95% CI: -0.63--0.15, P=0.002). There were no significant difference in the long diameter and short diameter between the two groups (mean difference=0.07, 95% CI: -0.33-0.20, P=0.631; mean difference=-0.03, 95% CI: -0.20-0.24, P=0.844). The tumor inactivation rate was 100% in both groups one month after treatment. The local tumor progression rate of the parallel placement group was lower than that of the simple placement group(2.70% vs 16.22%, P=0.037) at the median follow-up time of 6 months.

  Conclusions  A good tumor-inactivation rate was obtained in both two groups. The parallel placement could form a larger coagulation area and reduce the local tumor progression compared to the simple placement.