Abstract
Only 20-30% of patients with hepatocellular carcinoma can be candidates for hepatectomy because of underlying cirrhosis or multiple lesions. Even worse, 80% of patients who undergo "curative" resection develop recurrence within 5 years because of micrometastasis or metachronous multicentric carcinogenesis. Thus, non-surgical therapies play an important role in the treatment of hepatocellular carcinoma. Percutaneous radiofrequency ablation (RFA) has become widely performed because it is curative, minimally invasive, and can be performed multiple times. We have performed RFA on more than 2,500 patients. Among 556 patients who received RFA as the initial treatment, survival rates were 96% at 1 year, 88% at 2 years, 79% at 3 years, 69% at 4 years, and 55% at 5 years. Complications occurred in 4% of the cases. Only two out of over 2,500 patients died within 30 days. One died of cerebellar bleeding that occurred 7 days after RFA. The other died of ARDS and liver failure following pleural and peritoneal bleeding. Over 1,400 institutions have introduced RFA into clinical practice in Japan. However, not all groups have sufficient experience and skills. It is necessary to enrich training courses, set up a qualifying system, and control the quality of RFA in all institutions.
