title: The combined effect of radiofrequency and ethanol ablation in the management of large hepatocellular carcinoma.
abstract: Only a small percentage of patients with large hepatocellular carcinoma (HCC) may benefit out of surgical resection. Thus, most of these patients are in need of a form of local control, such as ethanol ablation, transarterial chemoembolization (TACE), radiofrequency thermal ablation (RF), or laser induced thermotherapy (LITT). The purpose of this study was to assess the short-term effect of sequential RF and ethanol ablation in the management of large HCC (>5 cm). Our series included 40 patients with large HCC tumors (>5 cm in diameter). We adopted a protocol of overlapping RF applications, followed by repeated ethanol ablation sessions. Our results showed that the volume of tumor coagulative necrosis initially induced by RF has significantly risen after adjuvant ethanol ablation sessions (P < 0.001). Patients who achieved complete tumor necrosis after RF ablation were 52.5% of the series. This percent has jumped to 80% of the series at the end of the protocol. This indicates that such combined protocol is more effective than RF alone. Besides, it is valuable in reducing the number of RF sessions.
authors.affiliation: Department of Radiation Sciences, Radiology Unit, Medical Research Institute, University of Alexandria, 165 Horreya Avenue, El Hadara, Alexandria, Egypt. aymansakr12345@hotmail.com
authors.forename: Ayman A
authors.initials: AA
authors.lastname: Sakr
authors.forename: Alaa Ahmed
authors.initials: AA
authors.lastname: Saleh
authors.forename: Amr Ali Abdel
authors.initials: AA
authors.lastname: Moeaty
authors.forename: Ali Abdel
authors.initials: AA
authors.lastname: Moeaty
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000431:Ethanol