Outcomes of ultrasound‐guided percutaneous argon‐helium cryoablation of hepatocellular carcinoma

Abstract Purpose To evaluate the efficacy and safety of ultrasound (US)‐guided percutaneous argon‐helium cryoablation for hepatocellular carcinoma (HCC) and determine appropriate indications. Methods We reviewed outcomes of 300 HCC patients who underwent US‐guided percutaneous cryoablation. Results Overall, 223 tumors (mean diameter 7.2 ± 2.8 cm) in 165 patients were incompletely ablated, while 185 tumors (mean diameter 5.6 ± 0.8 cm, P = 0.0001 vs. incomplete ablation) in 135 patients were completely ablated. Nineteen patients (6.3%) developed serious complications while in hospital, including cryoshock syndrome in six patients, hepatic bleeding in five, stress‐induced gastric bleeding in four, liver abscess in one and intestinal fistulas in one. Two patients died because of liver failure. The median follow‐up was 36.7 months (range 6–63 months). The local tumor recurrence rate was 31%, and was related to tumor size ( P = 0.029) and tumor location ( P = 0.037). The mean survival duration of patients with early, intermediate and advanced HCC (Barcelona Clinic Liver Cancer staging system) was 45.7 ± 3.8, 28.4 ± 1.2 and 17.7 ± 0.6 months, respectively. Conclusions US‐guided percutaneous cryoablation is a relatively safe and effective therapy for selected HCC patients.