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Purpose <p>To investigate the effectiveness and safety of ultrasound (US)-guided percutaneous radiofrequency ablation (PRFA) for sub-cardiac hepatic tumors and evaluate the factors influencing local tumor progression (LTP).</p> Methods <p>Between January 2016 and January 2023, we included 118 patients (118 lesions) of US-guided RFA for sub-cardiac hepatic tumors (located in S2 or S4a, with a gap between the tumor and the left diaphragm ≤ 10&#xa0;mm). We retrospectively analyzed patients’ electronic medical records and imaging follow-up data to evaluate the success rate, LTP, and complications. We also used univariate and multivariate Cox regression to explore the risk factors for LTP.</p> Results <p>The primary technical success rate for treating sub-cardiac hepatic tumors was 113/118 (95.8%). The success rate after the second ablation was 118/118 (100%). A single serious complication was recorded 1/118(0.8%), including acute pericardial tamponade and sudden cardiac arrest. The median follow-up period was 24 months (range, 1.2–72 months), with LTP occurring in 19 lesions (16.1%). Besides, the 1-year, 2-year, and 3-year cumulative rates of LTP were 12.7%, 15.3%, and 16.1%, respectively. Tumor size was an independent risk factor for LTP following ablation of sub-cardiac hepatic tumors (HR 1.06; 95% CI 1.02–1.11; <i>P</i> = 0.008). A larger minimal ablative margin (MAM) was associated with a lower hazard of LTP (HR 0.78; 95% CI 0.65–0.92; Wald <i>P</i> = 0.004; LR <i>P</i> = 0.002). Stratified analysis indicated that lesions ≥ 30&#xa0;mm in diameter carried a significantly higher risk of LTP (HR 4.35; 95% CI 1.46–12.99; <i>P</i> = 0.009).</p> Conclusions <p>US-guided PRFA for sub-cardiac hepatic tumors is effective and safe, though caution is advised for tumors ≥ 30&#xa0;mm due to a significantly higher LTP risk.</p>

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The local efficacy and influencing factors of ultrasound-guided percutaneous radiofrequency ablation in sub-cardiac hepatic tumor: A 7-year experience at a single center

  • 期刊论文

  • 发表日期：

    2026年4月27日

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  • Chunxu Liao,
  • Jianchuan Yang,
  • ZhiLiang Hong,
  • Xiantao Zeng,
  • Ting Hu,
  • Songsong Wu

摘要

Purpose

To investigate the effectiveness and safety of ultrasound (US)-guided percutaneous radiofrequency ablation (PRFA) for sub-cardiac hepatic tumors and evaluate the factors influencing local tumor progression (LTP).

Methods

Between January 2016 and January 2023, we included 118 patients (118 lesions) of US-guided RFA for sub-cardiac hepatic tumors (located in S2 or S4a, with a gap between the tumor and the left diaphragm ≤ 10 mm). We retrospectively analyzed patients’ electronic medical records and imaging follow-up data to evaluate the success rate, LTP, and complications. We also used univariate and multivariate Cox regression to explore the risk factors for LTP.

Results

The primary technical success rate for treating sub-cardiac hepatic tumors was 113/118 (95.8%). The success rate after the second ablation was 118/118 (100%). A single serious complication was recorded 1/118(0.8%), including acute pericardial tamponade and sudden cardiac arrest. The median follow-up period was 24 months (range, 1.2–72 months), with LTP occurring in 19 lesions (16.1%). Besides, the 1-year, 2-year, and 3-year cumulative rates of LTP were 12.7%, 15.3%, and 16.1%, respectively. Tumor size was an independent risk factor for LTP following ablation of sub-cardiac hepatic tumors (HR 1.06; 95% CI 1.02–1.11; P = 0.008). A larger minimal ablative margin (MAM) was associated with a lower hazard of LTP (HR 0.78; 95% CI 0.65–0.92; Wald P = 0.004; LR P = 0.002). Stratified analysis indicated that lesions ≥ 30 mm in diameter carried a significantly higher risk of LTP (HR 4.35; 95% CI 1.46–12.99; P = 0.009).

Conclusions

US-guided PRFA for sub-cardiac hepatic tumors is effective and safe, though caution is advised for tumors ≥ 30 mm due to a significantly higher LTP risk.