[Radiofrequency ablation of hepatocellular carcinoma in patients with cirrhosis].
Radiofrequency is an effective therapeutic modality for patients with hepatocellular carcinoma. However few data are available with regard to the complication rate, the feasibility and long term survival.


OBJECTIVE
To assess the response rate and complications of radiofrequency in cirrhotic patients with hepatocellular carcinoma.


METHODS
Eighteen patients were enrolled. Each nodule was treated subcutaneously. Treatment response was assessed by computed tomography performed at 24 hours in 10 patients and every 3 months in all patients. Necrosis of the tumor was considered complete when hypodensity without enhanced contrast.


RESULTS
Thirty hepatocellular carcinoma nodules with a mean tumor size of 30 mm; 15<30 mm and 15 >=30 mm, were treated by 1.3 radiofrequency sessions. Complete necrosis was achieved in 89%, greater for nodules<30 mm (100%) than for nodules >=30mm (80%). After a median follow up of 10.6 months, survival rate was 50%. Death was related to tumor involvement in 28%, to cirrhosis complications in 17% and to non liver-related disease in 5%. Three major treatment-related complications occurred (10%): subcapsular hematoma, sustained severe pain and peritoneal dissemination. All three complications were related to subcapsular location.


CONCLUSIONS
Radiofrequency may be considered as an alternative treatment to percutaneous ethanol injection for hepatocellular carcinoma; however, subcapsular location has to be excluded when considering the observed morbidity. Prospective studies are warranted to evaluate the efficacy and morbidity of this treatment in hepatocellular carcinoma.
Bonny
Corinne
C
Service d'hépato-Gastroentérologie, Hôtel Dieu, Boulevard Léon Malfreyt, BP 69, 63 003 Clermont-Ferrand, France. cbonny@chu-clermontfd.fr
Abergel
Armand
A
Gayard
Pierre
P
Chouzet
Stéphane
S
Ughetto
Sylvie
S
Slim
Karem
K
Rosenfeld
Ludovic
L
Guillon
Rémi
R
Poincloux
Laurent
L
Bommelaer
Gilles
G
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D002423:Cause of Death; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008107:Liver Diseases / Q000209:etiology; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009366:Neoplasm Seeding; D010149:Postoperative Pain / Q000209:etiology; D012720:Severity of Illness Index; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome