We have performed alternative methods of ablation, which are laparoscopic radiofrequency ablation (LRFA) and percutaneous radiofrequency ablation with artificial pleural effusion (PRFA with APE), for hepatocellular carcinoma (HCC) located close to the hepatic dome. HCC located in this area is considered to be difficult to achieve complete necrosis by radiofrequency ablation. We treated total 27 cases of HCCs located in this area. Nine and 18 cases were treated by LRFA and PRFA with APE, respectively. The tumor size and number of session in LRFA group were significantly high in PRFA with APE. As a result, 2-year survival rate in LRFA group (76%) and PRFA with APE group (80%) was not significantly different from standard PRFA (93%). Thus, LRFA and PRFA with APE were efficient approaches for HCC located in hepatic dome.
