Evaluation of the safety and efficacy of ultrasound-guided percutaneous radiofrequency ablation for hepatocellular carcinoma and liver metastases adjacent to the gallbladder

Figures & data

Figure 1. Flowchart shows patient selection. HCC: hepatocellular carcinoma; RFA: radiofrequency ablation.

Table 1. Characteristics of the patients with HCC and liver metastases.

	HCC	Liver metastases	p
Patient characteristics	n = 58	n = 55
Age (years)	60.2 ± 11.1	59.1 ± 11.3	.576
Sex (M/F)	48/10	32/23	.004
Child-Pugh class (A/B)	51 (87.9%)	55 (100%)	.042
Cirrhosis	58 (100%)	0 (0%)	.000
Tumor characteristics	n = 63	n = 55
Tumor size (cm)	2.4 ± 0.9	2.7 ± 0.9	.597
Distance (≤0.5 cm/>0.5 cm)	36/27	28/27	.498
Hydrodissection (with/without)	28/35	23/32	.774

Table 2. Gallbladder-related complications after RFA of HCC and liver metastases.

Group	Patients	Gallbladder-related complications
HCC	63	5
		Pain in the right upper abdomen, n = 3
		Pain in the right upper abdomen with thickening of the gallbladder wall, n = 1
		Pain in the right upper abdomen with nausea, n = 1
Liver metastases	55	8
		Pain in the right upper abdomen, n = 8

Table 3. Comparison of gallbladder-related complications after RFA between HCC and liver metastases adjacent to the gallbladder.

Group	Patients	Gallbladder-related complications	P
HCC	63	5 (7.9%)	.253^a
HCC ≤ 0.5 cm	36 (57.1%)	4 (11.1%)	.282^b
HCC > 0.5 cm	27 (42.9%)	1 (3.7%)
Liver metastases	55	8 (14.5%)
Liver metastases ≤ 0.5 cm	28 (50.9%)	7 (25%)	.025^c
Liver metastases > 0.5 cm	27 (49.1%)	1 (3.7%)

^aComparison of HCC incidence and liver metastasis.

^bComparing the incidence between HCC ≤0.5 cm and HCC 0.5–1 cm.

^cComparing the incidence between liver metastases ≤0.5 cm and 0.5–1 cm.

Table 4. Logistic analysis of factors influencing gallbladder-related complications after RFA between HCC and liver metastases adjacent to the gallbladder.

Risk factors	Wald test	HR	95% CI	p value
Child–Pugh class (A/B)	4.176	6.882	1.082–43.772	.041
Distance (≤0.5 cm/>0.5 cm)	5.852	7.449	1.464–37.910	.016
Hydrodissection (with/without)	4.436	4.741	1.114–20.178	.035

Figure 2. A 44-year-old female with HCC lesions in the S5 of the liver adjacent to the gallbladder underwent ultrasound-guided RFA.

A. The lesion in the S5 of the liver adjacent to the gallbladder, with a size of 2.6 × 2.2 cm. B. The gallbladder fossa was filled with saline (white arrow) using the hydrodissection technique. C. RFA (black arrow) with Celon double-needle for the HCC lesions near the gallbladder in the S5. D. 1 month after RFA S5 of the liver (black arrow), MRI showed no enhancement of the ablation lesion. The lesion achieved technical effectiveness.

Table 5. Technical effectiveness of radiofrequency ablation for liver tumors adjacent to the gallbladder.

Group	Patients	Technical effectiveness	p
HCC	63	63 (100%)	.053^a
≤3 cm	48 (76.2%)	48 (100%)	.036^b
>3 cm	15 (23.8%)	15 (100%)
Liver metastases	52	49 (94.2%)
≤3 cm	34 (65.4%)	31 (91.3%)
>3 cm	18 (34.6%)	18 (100%)

^aComparison of HCC with liver metastases.

^bComparison of HCC with liver metastases in the ≤3 cm group.

Data availability statement

The approval of data and material was obtained from participants.Consent for publication Not applicable.