Adjuvant percutaneous radiofrequency ablation of feeding artery of hepatocellular carcinoma before treatment.
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.
Hou
Yi-Bin
YB
Ultrasound Department, Peking University School of Oncology, Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China.
Chen
Min-Hua
MH
Yan
Kun
K
Wu
Jin-Yu
JY
Yang
Wei
W
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