Sonographically Guided Radiofrequency Ablation of Subcapsular Hepatocellular Carcinoma

Background: Radiofrequency ablation is an important and ideal treatment for hepatocellular carcinoma. However; subcapsular HCC carcinoma need special care to be treated by radiofrequency ablation. Objective: To evaluate the safety and effectiveness of percutaneous radiofrequency ablation (RFA) of sub-capsular hepatocellular carcinoma (HCC). Patients and Methods: We performed a retrospective analysis of 50 patients who underwent percutaneous ultrasound-guided RFA for treatment of HCC in Sohag University Hospital from May 2008 to April 2014. All lesions are subcapsular HCC (less than one cm from the capsule). All patients underwent contrast enhanced computed tomography imaging of the liver during follow-up and the treatment effectiveness and safety were evaluated. Incomplete ablation, recurrence, complications, and mortality were reported. Results: Complete ablation was achieved in 45 out 50 patients. Four patients were referred to chemo-embolization treatment. The 5th patient was lost to follow-up. Five major complications occurred in our series, namely sub-capsular hematoma (in 2 patients), pleural effusion (in 2 patients), transient ascites (in 1 patient), portal vein branch thrombosis (in 1 patient) and needle track tumour seeding (in 1 patient). No death was reported in our study. Conclusion: Subcapsular HCC carcinoma can be treated safely and effectively by RFA using cautious techniques by experienced operators to prevent complications.