1. Fotlos Laspas'. Evangelia Sotiropoitlou'. Sophia Myhna^. Anita Manataki', Paraskevi TsagouW. Iris Tsangaridou', Loukas Thanos'

2.  To evaluate the efficacy and complications of computed tomography (CT)-guided radiofrequency ablation (RFA) of unreseclable hepatocellular carcinoma

3.  A retrospective study of 282 patients  Males: 231  Females: 51  Age range: 44-76 years (Mean=62 years old) with HCC (322 lesions) who had been treated by CT-guided RFA over a period of 5 years  The diameter of the tumors: 1.5 to 5cm.

4. Diagnosed HCC Treated with CT-guided Radiofrequency Ablation for a period of 5 years Check for viability by dual-phase dynamic contrast enhanced CT (1 month after RFA) Follow-up (Dualphase dynamic contrast enhanced CT at 1,3 and 6 months post-RFA and every 6 months afterwards)

5. Evaluation of patient outcome, survival and recurrence rates were assessed (review of short and long term complications

6.  The ablation success rate: 87.3% (281/322 HCC nodules), while 41 (12.7%) lesions repeated RFA because of tumor residue.  The survival rates at 1 year : 94.8% 2 years: 86.6% 3 years: 73.1% 4 years: 64.2% 5 years: 51.1%

7.  A total number of 9 (2.8% per procedure) minor complications  No major complications were observed  Follow-up period, the local tumor progression rate: 22%  Recurrence rate of new intrahepatic nodules: 48%.

8.  The results of this study support that RFA is an effective and safe technique for the treatment of unresectable HCC.

9.  No randomization was done. It was a retrospective study Were all patients who entered the trial properly accounted for and attributed at its conclusion? Yes, all the 282 patients (231 males, 51 females; with the age range: 44-76 years; mean age: 62 years) with 322 lesions of HCC who underwent CT-guided RFA from February 2002 to February 2007 were accounted for at its conclusion. No drop- outs were reported.

10.  Yes, the follow- up was complete  The follow-up period ranged from 6 to 68 months (mean, 29 months) and included a dual-phase dynamic contrast enhanced CT at 1.3 and 6 months post-RFA and every 6 months afterwards

11. Were patients analyzed in the groups to which they were randomized? – Yes patients were analyzed however only one group of patients was studied. No randomization was done Were patients, health workers, and study personnel "blind" to treatment? – No blinding was done. It was a retrospective study. Were the groups similar at the start of the trial? – Yes.

12.  Yes. All patients were diagnosed by biopsy. They have all undergone laboratory examinations and received analgesic and anti-depressant prior to procedure.

13. Ablation success rate was 87.3% (281/322 HCC nodules), while 41 (12.7%) lesions were managed with repeated RFA because of tumor residue. The survival rates at 1, 2, 3, 4 and 5 years were 94.8%, 86.6%, 73.1%, 64.2% and 51.1%, respectively. A total number of 9 (2.8% per procedure) minor complications occurred. No major complications were observed. During the follow-up period, the local tumour progression rate was 22%, while the recurrence rate of new intrahepatic nodules was 48%.