Mid- to Long-term Outcome of Laparoscopic Ultrasound-guided Radiofrequency Ablation for Malignant Hepatic Tumors

Surgical resection remains the gold standard for the treatment of patients with hepatocellular carcinoma (HCC) and liver metastases (LM), especially those from colorectal cancers. However, the majority of patients are not candidates for surgical resection due to unresectable disease, the presence of extrahepatic disease, or concurrent medical conditions. Several authors have reported the long-term outcome of fully percutaneous radiofrequency ablation (RFA) for HCC and colorectal cancer liver metastasis (CRCLM). However, there are only a few studies on long-term outcomes, including local recurrence and survival, of fully laparoscopic ultrasound-guided radiofrequency ablation (LURFA) for patients with malignant hepatic tumors. This study is to evaluate the long-term outcomes of LURFA in malignant hepatic tumors that are difficult to be curatively treated with the percutaneous approach or laparoscopic liver resection (LLR) according to IWATE Criteria and the results show that full LURFA for malignant hepatic tumors is associated with low morbidity, low LR, and feasible outcomes even after long-term follow-up. It requires advanced skills for clearly identifying the target tumor, precise needle placement and constant real-time intraoperative ultrasound monitoring to achieve complete ablation and an effective oncological outcome.