title: Percutaneous radio-frequency thermal ablation of nonresectable hepatocellular carcinoma after occlusion of tumor blood supply.
abstract: OBJECTIVE
  To evaluate the usefulness of percutaneous radio-frequency (RF) thermal ablation of nonresectable hepatocellular carcinoma (HCC) after occlusion of the tumor arterial supply.
  
  
  METHODS
  Sixty-two patients with cirrhosis and biopsy-proved HCC underwent RF ablation after interruption of the tumor arterial supply by means of occlusion of either the hepatic artery with a balloon catheter (40 patients) or the feeding arteries with gelatin sponge particles (22 patients).
  
  
  RESULTS
  After a single RF procedure in 56 patients and after two procedures in six patients, spiral computed tomography (CT) demonstrated a nonenhancing area corresponding in shape to the previously identified HCC, which was suggestive of complete necrosis. No major complications occurred. Two patients subsequently underwent surgical resection; the remaining 60 patients were followed up with spiral CT. During a mean follow-up of 12.1 months, 11 HCC nodules showed areas of local progression; 49 were identified as nonenhancing areas with a 40%-75% reduction in maximum diameter. The 1-year estimate of failure risk was 19% for local recurrence and 45% for overall intrahepatic recurrence. The estimated 1-year survival was 87%. Histopathologic analysis of one autopsy and two surgical specimens revealed more than 90% necrosis in one specimen and 100% necrosis in two.
  
  
  CONCLUSIONS
  HCC nodules 3.5-8.5 cm in diameter can be ablated in one or two RF sessions after occlusion of the tumor arterial supply.
authors.affiliation: Depts of Gastroenterology, Emergency Medicine, and Radiology, Public Hospital of Piacenza, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Rossi
authors.forename: F
authors.initials: F
authors.lastname: Garbagnati
authors.forename: R
authors.initials: R
authors.lastname: Lencioni
authors.forename: H P
authors.initials: HP
authors.lastname: Allgaier
authors.forename: A
authors.initials: A
authors.lastname: Marchianò
authors.forename: F
authors.initials: F
authors.lastname: Fornari
authors.forename: P
authors.initials: P
authors.lastname: Quaretti
authors.forename: G D
authors.initials: GD
authors.lastname: Tolla
authors.forename: C
authors.initials: C
authors.lastname: Ambrosi
authors.forename: V
authors.initials: V
authors.lastname: Mazzaferro
authors.forename: H E
authors.initials: HE
authors.lastname: Blum
authors.forename: C
authors.initials: C
authors.lastname: Bartolozzi
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000601:surgery*; D002404:Catheterization; D003287:Contrast Media; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D005781:Gelatin Sponge, Absorbable; D006801:Humans; D008099:Liver / Q000098:blood supply*; D008113:Liver Neoplasms / Q000098:blood supply / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA