The effectiveness of local ablation for small hepatocellular carcinoma using artificial ascites

Local ablation is a minimally invasive treatment for hepatocellular carcinoma (HCC). However, the risk of thermal injury is increased in hepatic tumors in direct contact with other vital organs. Although artificial ascites can reduce the risk by separating the organs from the ablated tumor, whether it affects the effectiveness of local ablation remains unclear. This retrospective study screened patients with small HCC (<3 cm) treated with local ablation since May 2012 till January 2015. The primary endpoints are ablative volume and temperature at the end of treatment. The secondary endpoints include the rates of initial complete ablation and 1‐year local tumor progression. A total of 84 sessions of local ablation were performed for 76 tumors in 59 patients (36 males and 23 females; mean age, 66.44 ± 10.30 years). Artificial ascites was performed in 28 (33.3%) sessions. The artificial ascites group tended to have lower ablative volume and temperature than the controls ( P  = 0.089 and P  = 0.077). There was no difference in the rates of initial complete ablation and 1‐year local tumor progression between artificial ascites group and controls. Multivariate analyses showed that special location was significantly associated with initial complete ablation ( P  = 0.015). Local ablation with the assistance of artificial ascites is an effective therapy for difficult‐to‐ablate HCCs. Special location was associated with failure of initial complete ablation for small HCC rather than artificial ascites.