OUTCOMES OF RADIOFREQUENCY ABLATION FOR HEPATOCELLULAR CARCINOMA WITH A MINIMUM 2-YEAR FOLLOW-UP AT BACH MAI HOSPITAL
Main Article Content
Abstract
Background: Hepatocellular carcinoma (HCC) is one of the most common and lethal cancers in Vietnam. Radiofrequency ablation (RFA) is a standard treatment for early-stage HCC; however, domestic studies with a minimum 2-year follow-up are limited.
Objectives: (1) To describe clinical, paraclinical, and imaging characteristics; (2) To evaluate RFA outcomes for HCC with a minimum 2-year follow-up at Bach Mai Hospital.
Methods: A retrospective descriptive longitudinal study of 74 HCC tumors (57 patients) treated with RFA at Bach Mai Hospital, followed for a minimum of 24 months. Endpoints included complete ablation rate, local recurrence rate, OS, DFS at 12, 18, and 24 months, and complication rates.
Results: Mean age 62.4 years (range 23–87), male/female ratio 68/6. Hepatitis B was the main risk factor (82.4%). Mean tumor diameter 18.2 mm (range 6–43 mm); 92% BCLC stage 0 or A. Immediate complete ablation rate was 94.6%. At 2 years, local recurrence rate was 20.3%, OS was 98.2%, and DFS was 57,9%. High-risk location was associated with higher recurrence (33.3% vs. 14.0%). Complication rate was 16.2%, all grade I–II, with no procedure-related mortality.
Conclusion: RFA is a safe and effective treatment for early-stage HCC at Bach Mai Hospital, with high complete ablation rate and high 2-year overall survival.
Keywords: Hepatocellular carcinoma, radiofrequency ablation, RFA, recurrence.
Keywords
Hepatocellular carcinoma, radiofrequency ablation, RFA, recurrence
Article Details
References
mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-263. doi:10.3322/caac.21834
2. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality
Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-249. doi:10.3322/caac.21660
3. Galle PR, Forner A, Llovet JM, et al. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma.
J Hepatol. 2018;69(1):182-236. doi:10.1016/j.jhep.2018.03.019
4. Marrero JA, Kulik LM, Sirlin CB, et al. Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018
Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology. 2018;68(2):723-750.
doi:10.1002/hep.29913
5. Modified RECIST (mRECIST) Assessment for Hepatocellular Carcinoma - PMC. Accessed June 14, 2026. https://
pmc.ncbi.nlm.nih.gov/articles/PMC12268942/
6. Feng K, Yan J, Li X, et al. A randomized controlled trial of radiofrequency ablation and surgical resection in the
treatment of small hepatocellular carcinoma. J Hepatol. 2012;57(4):794-802. doi:10.1016/j.jhep.2012.05.007
7. Liu CJ, Kao JH. Hepatitis B Virus-related Hepatocellular Carcinoma: Epidemiology and Pathogenic Role of Viral
Factors. J Chin Med Assoc. 2007;70(4):141-145. doi:10.1016/S1726-4901(09)70346-6
8. Chen C, Zhao H, Wang S, et al. Contrast-enhanced computed tomography plus gadolinium-ethoxybenzyl
diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging for gross classification of hepatocellular
carcinoma. Oncotarget. 2017;8. doi:10.18632/oncotarget.15712
9. Small Hepatocellular Carcinoma in Cirrhosis: Randomized Comparison of Radio-frequency Thermal Ablation
versus Percutaneous Ethanol Injection | Radiology. Accessed June 14, 2026. https://pubs.rsna.org/doi/10.1148/
radiol.2281020718
10. Livraghi T, Meloni F, Di Stasi M, et al. Sustained complete response and complications rates after radiofrequency
ablation of very early hepatocellular carcinoma in cirrhosis: Is resection still the treatment of choice? Hepatology.
2008;47(1):82-89. doi:10.1002/hep.21933
11. Luu VD, Tan DD, Thong PM, et al. Vietnamese expert consensus on the treatment of hepatocellular carcinoma
with transarterial chemoembolization. Front Radiol. 2026;6. doi:10.3389/fradi.2026.1763042
12. Yamakado K, Nakatsuka A, Takaki H, et al. Early-Stage Hepatocellular Carcinoma: Radiofrequency Ablation
Combined with Chemoembolization versus Hepatectomy. Radiology. 2008;247(1):260-266. doi:10.1148/
radiol.2471070818
13. Mulier S, Mulier P, Ni Y, et al. Complications of radiofrequency coagulation of liver tumours. Br J Surg. 2002;89:1206-
1222. doi:10.1046/j.1365-2168.2002.02168.x
14. Shiina S, Tateishi R, Arano T, et al. Radiofrequency Ablation for Hepatocellular Carcinoma: 10-Year Outcome and
Prognostic Factors. Am J Gastroenterol. 2011;107:569-577; quiz 578. doi:10.1038/ajg.2011.425
15. Intrahepatic recurrence after percutaneous radiofrequency ablation of hepatocellular carcinoma: Analysis of the
pattern and risk factors. Eur J Radiol. 2006;59(3):432-441. doi:10.1016/j.ejrad.2006.03.007
16. Influence of Large Peritumoral Vessels on Outcome of Radiofrequency Ablation of Liver Tumors. J Vasc Interv
Radiol. 2003;14(10):1267-1274. doi:10.1097/01.RVI.0000092666.72261.6B
17. Shiina S, Tateishi R, Imamura M, et al. Percutaneous ethanol injection for hepatocellular carcinoma: 20-year
outcome and prognostic factors. Liver Int. 2012;32(9):1434-1442. doi:10.1111/j.1478-3231.2012.02838.x
18. Hepatocellular carcinoma. The Lancet. 2012;379(9822):1245-1255. doi:10.1016/S0140-6736(11)61347-0
19. Rhim H, Dodd G, Chintapalli K, et al. Radiofrequency Thermal Ablation of Abdominal Tumors: Lessons Learned
from Complications. Radiogr Rev Publ Radiol Soc N Am Inc. 2004;24:41-52. doi:10.1148/rg.241025144