title: Radiofrequency ablation with internally cooled versus perfused electrodes for the treatment of small hepatocellular carcinoma in patients with cirrhosis.
abstract: OBJECTIVE
  To compare the results of radiofrequency (RF) ablation with internally cooled electrodes (ICEs) versus perfused electrodes (PEs) in patients with cirrhosis with small (<or=3 cm) hepatocellular carcinoma ineligible for resection.
  
  
  METHODS
  Patients treated with RF ablation over two consecutive periods were analyzed retrospectively. From 2000 to 2002, 45 patients were treated with 17-gauge ICEs, and from 2002 to 2004, 44 patients were treated with 15-gauge PEs. The two groups were similar in age, sex, Child-Pugh stage, serum alpha-fetoprotein (AFP) level, and size and number of tumors (54 tumors in each group). Results were assessed by contrast medium-enhanced CT.
  
  
  RESULTS
  In both groups, 52 of 54 tumors (96.3%) were completely ablated. Eight of 54 tumors (14.8%) treated with ICEs and 39 of 54 tumors (72.2%) treated with PEs required multiple RF applications (P<.00005). In the respective groups, one of 54 tumors (1.8%) and seven of 54 tumors (12.9%) required multiple RF sessions (P=.03). Complication rates were similar. The 2-year probabilities of local and distant (ie, separated from the ablation zone) tumor progression in the ICE and PE groups were 11% and 15%, respectively (P=.65), and 31% and 64% (P=.01), respectively. On multivariate analysis, serum AFP level greater than 100 ng/mL (P=.006) and the use of a PE (P=.003) were risk factors for distant tumor progression.
  
  
  CONCLUSIONS
  RF ablation with the use of a PE requires more applications and sessions and is associated with a higher risk of distant tumor progression compared with the use of an ICE.
authors.affiliation: Department of Radiology, Hôpital Jean Verdier, Assistance Publique-Hôpitaux de Paris/Centre Hospitalier Universitaire Paris XIII, Bondy, France. olivier.seror@jvr.aphp.fr
authors.forename: Olivier
authors.initials: O
authors.lastname: Seror
authors.forename: Gisèle
authors.initials: G
authors.lastname: N'Kontchou
authors.forename: Myint
authors.initials: M
authors.lastname: Tin-Tin-Htar
authors.forename: Corinne
authors.initials: C
authors.lastname: Barrucand
authors.forename: Nathalie
authors.initials: N
authors.lastname: Ganne
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Coderc
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Trinchet
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sellier
authors.forename: Michel
authors.initials: M
authors.lastname: Beaugrand
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation*; D003080:Cold Temperature; D018450:Disease Progression; D004566:Electrodes; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D012965:Sodium Chloride