Safety and Efficacy of Percutaneous Cryoablation for Small Hepatocellular Carcinomas Adjacent to the Heart.

ABSTRACT

PURPOSE: This study evaluated the safety and efficacy of percutaneous cryoablation for treatment of the left subdiaphragmatic small hepatocellular carcinomas (HCCs) adjacent to the heart. MATERIALS AND METHODS: Between September 2013 and March 2018, 189 consecutive patients underwent cryoablation for small HCCs (≤3 cm); 70 patients (mean 61.3 ± 10.6 years of age; range 40-82 years) with left hepatic tumors (22 juxtacardiac and 48 nonjuxtacardiac tumors) were retrospectively analyzed. Patients were divided into juxtacardiac and nonjuxtacardiac tumor groups (tumor margins ≤10 mm and >10 mm, respectively, from the heart border). The rates of technical success, complete ablation, complications, and local tumor recurrence (LTR) were evaluated. RESULTS: No significant intergroup differences were observed in the mean diameter of the tumor (17.9 ± 5.5 mm vs. 17.5 mm ± 5.2, respectively; P = 0.781) and of the ablation zone (41.3 ± 4.2 mm vs. 43.5 ± 5.8 mm, respectively; P = 0.115). Technical success was achieved in all patients. No procedure-related major complications occurred in either group. The median follow-up period was 15 months (range 3.1-49.6 months). No statistically significant intergroup differences were observed in the rates of complete ablation (90.9% vs. 93.8%, respectively; P = 0.646) and LTR (20% vs. 15.6%, respectively; P = 0.725). CONCLUSIONS: Cryoablation is a safe treatment modality for patients with juxtacardiac small HCCs, without an increased risk of cardiac complications compared to treatment of HCCs that are nonjuxtacardiac, and with comparable efficacy.