title: [Ultrasound-guided percutaneous composite thermal ablation technique in treatment of medium and large hepatocellular carcinoma].
abstract: OBJECTIVE
  To evaluate the clinical values of ultrasound-guided percutaneous composite thermal ablation technique in the treatment of medium and large hepatocellular carcinoma (HCC).
  
  
  METHODS
  By the composite technique of multiple-needle insertion and multi-point energy application, ultrasound-guided percutaneous radiofrequency ablation (RFA) or microwave ablation (MWA) were employed to treat 68 patients of HCC with tumor nodule > or = 3.1 cm in diameter. There was a total number of 73 tumor nodules, with a mean diameter of (4.5 +/- 1.7) cm (3.1-13.0 cm). Sixty-three patients had single tumor nodule, and the remaining 5 had 2 nodules. With a follow-up time of 1.9 - 67.6 months [(16.0 +/- 14.8) months], the local and long-term efficacy was analyzed.
  
  
  RESULTS
  Hepatic subcapsular hematoma were found in 1 patient. And skin burning in 1 patient 1. Complete ablation rate was 78.1% (57/73), local tumor progression was presented in 24.6% tumor nodules (14/57) and distant recurrence developed in 56.7% patients (38/67). The 1-, 3-, 5-years survival rate was 62.3%, 29.6% and 21.6%, respectively, with a median survival time of 18.6 months, (95% confidence interval: 10.9 months, 26.3 months). There were no remarkable differences in complete ablation rate, local tumor progression, distant recurrence rate and survival rate between RFA and MWA.
  
  
  CONCLUSIONS
  By the composite ablation technique, ultrasound-guided percutaneous thermal ablation was effective in treating medium and large unresectable HCC. And the advantage is minimal invasiveness. RFA and MWA had no marked differences in terms of therapeutic efficacy.
authors.affiliation: Department of Hepatobiliary Surgery, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
authors.forename: Xiao-yu
authors.initials: XY
authors.lastname: Yin
authors.forename: Xiao-yan
authors.initials: XY
authors.lastname: Xie
authors.forename: Ming-de
authors.initials: MD
authors.lastname: Lü
authors.forename: Jun-wei
authors.initials: JW
authors.lastname: Chen
authors.forename: Hui-xiong
authors.initials: HX
authors.lastname: Xu
authors.forename: Zuo-feng
authors.initials: ZF
authors.lastname: Xu
authors.forename: Guang-jian
authors.initials: GJ
authors.lastname: Liu
authors.forename: Bei
authors.initials: B
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional