Combined hepatectomy and radiofrequency ablation for multifocal hepatocellular carcinomas: Long-term follow-up results and prognostic factors

Dongil Choi, Hyo K. Lim, Jae Won Joh, Sung Joo Kim, Min Ju Kim, Hyunchul Rhim, Young Sun Kim, Byung Chul Yoo, Seung Woon Paik, Cheol Keun Park

Research output: Contribution to journalArticlepeer-review

55 Citations (Scopus)


Background: For multifocal hepatocellular carcinomas (HCCs) that are untreatable with resection only, locoregional therapies added to hepatectomy have been introduced. However, some preliminary reports have documented average survival results and relatively high complication rates. We evaluated the long-term survival results and safety of combined hepatectomy and radiofrequency ablation (RFA) in patients with HCCs and assessed the prognostic factors affecting their survival. Methods: A total of 53 patients who had 148 HCCs in their livers underwent hepatectomy combined with ultrasound-guided intraoperative RFA. The mean diameter of the 82 resected tumors was 4.8 cm (range 1.3-21.0 cm) and that of 66 ablated tumors was 1.5 cm (range 0.8-3.5 cm). We evaluated the primary effectiveness rates, survival rates, and complications. In addition, we assessed the prognostic factors associated with the survival rates using Cox proportional hazard models. Results: The primary effectiveness rate of RFA was 98% (65 of 66). Local tumor progression was observed in two (3%) ablation zones of 65 tumors with complete primary effectiveness. The cumulative survival rates at 1, 2, 3, 4, and 5 years were 87, 83, 80, 68, and 55%, respectively. Patients with smaller resected tumors (≤5 cm) demonstrated better survival results (P = 0.004). No procedure-related deaths occurred. We observed hepatectomy-related complications in 4 patients (8%, 4 of 53) and an RFA-related complication in 1 patient (2%, 1 of 53). Conclusions: Combined hepatectomy and RFA is an effective and safe treatment modality for multifocal HCCs. Resected tumor size was a significant prognostic predictor of long-term survival.

Original languageEnglish
Pages (from-to)3510-3518
Number of pages9
JournalAnnals of Surgical Oncology
Issue number12
Publication statusPublished - 2007 Dec
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by a grant from the Samsung Medical Center Clinical Research Development Program. We thank Kyong Hee Lee and Kyung Mi Lee at Samsung Biomedical Research Institute for the collection of data, and all members of the Liver Cancer Center of Samsung Medical Center.


  • Combined treatment
  • Hepatectomy
  • Hepatocellular Carcinoma
  • Prognostic Factors
  • Radiofrequency Ablation
  • Survival

ASJC Scopus subject areas

  • Surgery
  • Oncology


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