title: Adjuvant percutaneous radiofrequency ablation of feeding artery of hepatocellular carcinoma before treatment.
abstract: OBJECTIVE
  To evaluate the feasibility and efficacy of percutaneous radiofrequency ablation (RFA) of the feeding artery of hepatocellular carcinoma (HCC) in reducing the blood-flow-induced heat-sink effect of RFA.
  
  
  METHODS
  A total of 154 HCC patients with 177 pathologically confirmed hypervascular lesions participated in the study and were randomly assigned into two groups. Seventy-one patients with 75 HCCs (average tumor size, 4.3 +/- 1.1 cm) were included in group A, in which the feeding artery of HCC was identified by color Doppler flow imaging, and were ablated with multiple small overlapping RFA foci [percutaneous ablation of feeding artery (PAA)] before routine RFA treatment of the tumor. Eighty-three patients with 102 HCC (average tumor size, 4.1 +/- 1.0 cm) were included in group B, in which the tumors were treated routinely with RFA. Contrast-enhanced computed tomography was used as post-RFA imaging, when patients were followed-up for 1, 3 and 6 mo.
  
  
  RESULTS
  In group A, feeding arteries were blocked in 66 (88%) HCC lesions, and the size of arteries decreased in nine (12%). The average number of punctures per HCC was 2.76 +/- 1.12 in group A, and 3.36 +/- 1.60 in group B (P = 0.01). The tumor necrosis rate at 1 mo post-RFA was 90.67% (68/75 lesions) in group A and 90.20% (92/102 lesions) in group B. HCC recurrence rate at 6 mo post-RFA was 17.33% (13/75) in group A and 31.37% (32/102) in group B (P = 0.04).
  
  
  CONCLUSIONS
  PAA blocked effectively the feeding artery of HCC. Combination of PAA and RFA significantly decreased post-RFA recurrence and provided an alternative treatment for hypervascular HCC.
authors.affiliation: Ultrasound Department, Peking University School of Oncology, Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China.
authors.forename: Yi-Bin
authors.initials: YB
authors.lastname: Hou
authors.forename: Min-Hua
authors.initials: MH
authors.lastname: Chen
authors.forename: Kun
authors.initials: K
authors.lastname: Yan
authors.forename: Jin-Yu
authors.initials: JY
authors.lastname: Wu
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy; D017115:Catheter Ablation / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D017078:Laser-Doppler Flowmetry; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy; D008297:Male; D009389:Neovascularization, Pathologic / Q000473:pathology / Q000628:therapy; D018714:Radiotherapy, Adjuvant