Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection.
OBJECTIVE
To compare the effectiveness of radio-frequency (RF) ablation with that of percutaneous ethanol injection in the treatment of small hepatocellular carcinoma (HCC).


METHODS
Eighty-six patients with 112 small (< or = 3-cm-diameter) HCCs underwent RF ablation (42 patients with 52 tumors) or percutaneous ethanol injection (44 patients with 60 tumors). Therapeutic efficacy was evaluated with dual-phase spiral computed tomography performed at least 4 months after treatment.


RESULTS
Complete necrosis was achieved in 47 of 52 tumors with RF ablation (90%) and in 48 of 60 tumors with percutaneous ethanol injection (80%). These results were obtained with an average of 1.2 sessions per tumor with RF ablation and 4.8 sessions per tumor with percutaneous ethanol injection. One major complication (hemothorax that required drainage) and four minor complications (intraperitoneal bleeding, hemobilia, pleural effusion, cholecystitis) occurred in patients treated with RF ablation; no complications occurred in patients treated with percutaneous ethanol injection.


CONCLUSIONS
RF ablation results in a higher rate of complete necrosis and requires fewer treatment sessions than percutaneous ethanol injection. However, the complication rate is higher with RF ablation than with percutaneous ethanol injection. RF ablation is the treatment of choice for most patients with HCC.
Livraghi
T
T
Department of Radiology, Ospedale Civile, Vimercate, Italy.
Goldberg
S N
SN
Lazzaroni
S
S
Meloni
F
F
Solbiati
L
L
Gazelle
G S
GS
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D002764:Cholecystitis / Q000209:etiology; D015331:Cohort Studies; D004322:Drainage; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006431:Hemobilia / Q000209:etiology; D006491:Hemothorax / Q000209:etiology / Q000628:therapy; D006801:Humans; D015552:Injections, Intralesional; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D008297:Male; D009336:Necrosis; D010996:Pleural Effusion / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000209:etiology; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
D000970:Antineoplastic Agents; D000431:Ethanol