Results of successful application of radiofrequency ablation in the treatment of hepatocellular carcinoma (HCC)

BACKGROUND: One of the surgical treatment methods for hepatocellular carcinoma is energy-based tumor ablation, indicated in patients with BCLC stage 0 and stage A disease when liver resection or transplantation is not feasible. CASE DESCRIPTION: A 72-year-old patient with hepatocellular carcinoma, cT1bN0M0 (stage IB), underwent percutaneous radiofrequency ablation because of severe comorbidities, including cirrhosis secondary to nonalcoholic steatohepatitis, Child-Pugh class B (7 points), portal hypertension, dilatation of the portal venous system, portosystemic shunts, grade 1 ascites, splenomegaly, and grade 2 esophageal varices (endoscopic ligation of grade 2 varices was performed in 2018), as well as type 2 diabetes mellitus. Chest and abdominal computed tomography with intravenous contrast at 3, 6, and 9 months after the procedure revealed no evidence of tumor progression. CONCLUSION: At the P. Hertsen Moscow Oncology Research Institute, the results of successful radiofrequency ablation in hepatocellular carcinoma were analyzed. The method demonstrated favorable short-term outcomes, a minimal number of complications, and favorable long-term outcomes, with overall 5-year survival reaching 94% of cases and overall 10-year survival 32.3% of cases, including patients with severe comorbidities. Over the past 10 years, at the P. Hertsen Moscow Oncology Research Institute, radiofrequency ablation has been used as an independent treatment modality in 5 patients. Overall 3-year recurrence-free survival was achieved in 80% of patients (4 patients), and overall 5-year survival in 20% of patients (1 patient).