Radiofrequency ablation for treatment of hepatocellular carcinoma with cirrhosis.
OBJECTIVE
The majority of hepatocellular carcinoma patients with cirrhosis are not candidates for surgical resection, and local thermal therapy producing destruction of cancer cells was one of the ideal options for treatment. Heat from radiofrequency ablation is generated through agitation caused by an alternating electrical current. The heat of radiofrequency energy results in local cell coagulation and causes cellular ablation necrosis of tumor tissue.


METHODS
Eighteen cases of hepatocellular carcinoma were treated with radiofrequency ablation in our institute. We used a RFA 2000 generator (Boston Scientific Co, USA) with LeVeen needle with the maximum diameter of 3.5 cm when the array electrodes were fanned out. The indications for this method included; i) normal prothrombin profile, ii) no ascites, iii) tumor can be detected and approached by ultrasound, iv) tumor cannot be resected or patient is not willing to take the operation.


RESULTS
No specific complication was noted during or after the procedure. Only two cases needed more analgesics after the procedure. One case was found with burning of the stomach serosa proved by laparoscopic examination, in which radiofrequency ablation was performed to the tumor located in the left lobe of the segment 3. Impedance could not raise up completely in two cases with larger size tumor more than 5 cm. The decreased levels of alpha-fetoprotein were significant (P = 0.005) after radiofrequency ablation treatment. Residual tumor was found in four cases (20%) in the follow-up abdominal computed tomography scan.


CONCLUSIONS
Radiofrequency ablation resulted in a higher rate of complete necrosis of tumor tissue and the complication rate was low as well. Therefore, we believed that radiofrequency ablation is an ideal treatment modality for most liver tumors, which cannot tolerate the conventional surgical procedures.
Lo
Hoi-Wan
HW
Division of Hepatology, Institute of Hepato-Gastroenterology, Yuan's General Hospital, No. 162, Cheng Kung 1st Rd, Kaohsiung 80211, Taiwan.
Tsai
Yu-Jou
YJ
Chen
Po-Hai
PH
Chen
Hong-Yaw
HY
Ker
Chen-Guo
CG
Juan
Chung-Chou
CC
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging / Q000473:pathology; D010166:Palliative Care; D014057:Tomography, X-Ray Computed