Single-session combined therapy with chemoembolization and radiofrequency ablation in hepatocellular carcinoma less than or equal to 5 cm: a preliminary study.
OBJECTIVE
To evaluate the efficacy and safety of a single-session combined chemoembolization and radiofrequency (RF) ablation for hepatocellular carcinomas (HCCs) less than or equal to 5 cm.


METHODS
Between June 1, 2004, and January 1, 2006, 50 patients (41 men, nine women; age range, 35-77 years; mean age, 61.5 years) with 57 HCCs (1.5-4.5 cm; mean, 2.4 cm) underwent single-session combined therapy. Chemoembolization was performed by using a doxorubicin hydrochloride/iodized oil emulsion with or without gelatin sponge particles. Immediately following chemoembolization, RF ablation was performed under fluoroscopy or ultrasonographic guidance. Initial tumor response and local tumor progression were determined with follow-up computed tomography or magnetic resonance imaging. The recurrence-free and overall survival rates as well as procedure-related complications were evaluated.


RESULTS
At 1-month follow up, complete necrosis was achieved in all index tumors; however, nonindex intrahepatic recurrences were found in two patients (complete response in 48 patients and progressive disease in two patients). The estimated 1- and 3-year local tumor progression rates during the follow-up period (range, 13.1-51.6 months; mean, 29.0 months) were 1.8% and 9.4%, respectively. The 1- and 3-year recurrence-free and overall survival rates were 64.6% and 30.5% and 100% and 79.7%, respectively. Three of the 50 patients (6%) had major complications, including segmental hepatic infarction (n = 2) and hepatic arterial bleeding (n = 1).


CONCLUSIONS
Single-session combined therapy is an effective and safe treatment for HCCs less than or equal to 5 cm.
Kang
Sung-Gwon
SG
Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi 463-707, Seoul, Korea.
Yoon
Chang Jin
CJ
Jeong
Sook-Hyang
SH
Kim
Jin Wook
JW
Lee
Sang Hyub
SH
Lee
Kyung Ho
KH
Kim
Young Hoon
YH
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D017115:Catheter Ablation / Q000009:adverse effects; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010865:Pilot Projects; D015641:Radiography, Interventional; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D000903:Antibiotics, Antineoplastic; D007459:Iodized Oil; D004317:Doxorubicin