Radiofrequency ablation of XXXX in difficult locations: Strategies and long-term outcomes.

@entity1 @entity157 @entity5 @entity39
AIM: To investigate the treatment strategies and long-term outcomes of radiofrequency ablation (RFA) of @entity157 ( @entity157 ) in difficult locations and to compare the results with non-difficult @entity157 . METHODS: From 2004 to 2012, a total of 470 @entity157 @entity1 underwent ultrasound-guided percutaneous RFA. Among these @entity157 @entity1 , 382 with @entity5 located  <= 5 mm from a major vessel/bile duct (n = 87), from peripheral important structures (n = 232) or from the liver capsule (n = 63) were regarded as difficult cases. There were 331 male @entity1 and 51 female @entity1 , with an average age of 55.3    10.1 years old. A total of 235 and 147 @entity1 had @entity1 -Pugh class A and class B liver function, respectively. The average @entity5 size was 3.4    1.2 cm. Individual treatment strategies were developed to treat these difficult cases. During the same period, 88 @entity157 @entity1 with @entity5 that were not in difficult locations served as the control group. In the control group, 74 @entity1 were male, and 14 @entity1 were female, with an average age of 57.4    11.8 years old. Of these, 62 @entity1 and 26 @entity1 had @entity1 -Pugh class A and class B liver function, respectively. Regular follow-up after RFA was performed to assess treatment efficacy. Survival results were generated from Kaplan-Meier estimates, and multivariate analysis was performed using the Cox regression model. RESULTS: Early @entity5 @entity39 rate in the difficult group was similar to that in the control group (97.6% vs 94.3%, P = 0.080). The complication rate in the difficult group was significantly higher than that in the control group (4.9% vs 0.8%, P = 0.041). The follow-up period ranged from 6 to 116 mo, with an average of 28    22.4 mo. Local progression rate in the difficult group was significantly higher than that in the control group (12.7% vs 7.1%, P = 0.046). However, the 1-, 3-, 5-, and 7-year overall survival rates in the difficult group were not significantly different from those in the control group (84.3%, 54.4%, 41.2%, and 29.9% vs 92.5%, 60.3%, 43.2%, and 32.8%, respectively, P = 0.371). Additionally, a multivariate analysis revealed that @entity5 location was not a significant risk factor for survival. CONCLUSION: There was no significant difference in long-term overall survival between the two groups even though the local progression rate was higher in the difficult group.
