Hepatocellular carcinoma: radio-frequency ablation of medium and large lesions.
OBJECTIVE
To study local therapeutic efficacy, side effects, and complications of radio-frequency (RF) ablation in the treatment of medium and large hepatocellular carcinoma (HCC) lesions in patients with cirrhosis or chronic hepatitis.


METHODS
One-hundred fourteen patients who were under conscious sedation or general anesthesia had 126 HCCs greater than 3.0 cm in diameter treated with RF by using an internally cooled electrode. Eighty tumors were medium (3.1-5.0 cm), and 46 were large (5.1-9.5 cm). The mean diameter for all tumors was 5.4 cm. At imaging, 75 tumors were considered noninfiltrating, and 51 were considered infiltrating.


RESULTS
Complete necrosis was attained in 60 lesions (47.6%), nearly complete (90%-99%) necrosis in 40 lesions (31.7%), and partial (50%-89%) necrosis in the remaining 26 lesions (20.6%). Medium and/or noninfiltrating tumors were treated successfully significantly more often than large and/or infiltrating tumors. Two major complications (death, hemorrhage requiring laparotomy) and five minor complications (self-limited hemorrhage, persistent pain) were observed. The single death was due to a break in sterile technique rather than to the RF procedure itself.


CONCLUSIONS
RF ablation appears to be an effective, safe, and relatively simple procedure for the treatment of medium and large HCCs.
Livraghi
T
T
Department of Radiology, Ospedale Civile, Vimercate, Italy. lalivra@tin.it
Goldberg
S N
SN
Lazzaroni
S
S
Meloni
F
F
Ierace
T
T
Solbiati
L
L
Gazelle
G S
GS
D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000628:therapy*; D016292:Procedural Sedation; D004867:Equipment Design; D005260:Female; D019694:Hepatitis B, Chronic / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D006979:Hyperthermia, Induced / Q000295:instrumentation*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000628:therapy; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000295:instrumentation*