Percutaneous Sonographically Guided Saline-Enhanced Radiofrequency Ablation of Hepatocellular Carcinoma

• Published in: American journal of roentgenology (1976) Vol. 181; no. 2; pp. 479 - 484
• Main Authors: Giorgio, Antonio, Tarantino, Luciano, de Stefano, Giorgio, Scala, Vincenzo, Liorre, Giulia, Scarano, Ferdinando, Perrotta, Anna, Farella, Nunzia, Aloisio, Vincenza, Mariniello, Nicola, Coppola, Carmine, Francica, Giampiero, Ferraioli, Giovanna
• Format: Journal Article
• Language: English
• Published: Leesburg, VA Am Roentgen Ray Soc 01-08-2003; American Roentgen Ray Society
• Subjects: Aged; Biological and medical sciences; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - surgery; Catheter Ablation; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Liver Cirrhosis - complications; Liver Neoplasms - complications; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - surgery; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Sodium Chloride - administration & dosage; Tomography, X-Ray Computed; Tumors; Ultrasonography, Interventional; Sonography; Short term; Human; Hepatic disease; Hepatocellular carcinoma; Malignant tumor; Radiofrequency; Ablation; Percutaneous route; Guidance; Cirrhosis; Efficiency; Echography; Digestive diseases; Complication; Technique; Saline solution
• ISSN: 0361-803X; 1546-3141
• DOI: 10.2214/ajr.181.2.1810479

The purpose of our study was to analyze the efficacy, side effects, and short-term complications of saline-enhanced percutaneous radiofrequency ablation performed under sonographic guidance in a series of cirrhotic patients with hepatocellular carcinoma. SUBJECTS AND METHODS. Between September 2000 and June 2002, 84 patients (55 men and 29 women) with cirrhosis who ranged in age from 48 to 74 years (mean age, 64 years) and who had 95 hepatocellular carcinomas (seven patients had two tumors and two patients had three tumors) were treated with high frequency-induced thermotherapy. The diameters of the tumors ranged from 1.5 to 8.5 cm (mean, 3.6 cm). The efficacy of radiofrequency ablation was evaluated with triphasic contrast-enhanced CT performed 4 weeks after the procedure.
Posttreatment CT showed complete necrosis in 73 (77%) of 95 hepatocellular carcinomas in 62 patients. Complete necrosis based on tumor size was seen in 40 (95%) of 42 tumors with diameters equal to or smaller than 3 cm, 32 (71%) of 45 tumors with diameters between 3.1 and 5.0 cm, and one (12%) of eight tumors with diameters larger than 5.0 cm. Twenty-two hepatocellular carcinomas showed incomplete necrosis. None of the patients experienced major complications. Four patients were lost to follow-up. The length of the follow-up period ranged from 4 to 22 months (mean, 10 months). One patient died 8 months after the radiofrequency ablation treatment. All the remaining patients are still alive. During the follow-up period, eight (10%) of 80 patients showed a local recurrence on sonography and CT.
Our experience suggests that percutaneous radiofrequency ablation of hepatocellular carcinoma with high frequency-induced thermotherapy is safe and effective in the treatment of hepatocellular carcinomas equal to or smaller than 3 cm, fairly effective for hepatocellular carcinomas between 3 and 5 cm, and ineffective for tumors larger than 5 cm.