title: Radiofrequency ablation of hepatocellular carcinoma extended into the portal vein: Preliminary results.
abstract: BACKGROUND
  We report our preliminary results of radiofrequency (RF) ablation of hepatocellular carcinoma (HCC) and neoplastic portal thrombus (NPT) in cirrhotic patients.
  
  
  METHODS
  Ten patients (7 males and 3 females; mean age 68 yrs) with 10 HCC nodules (37-49 mm) extended into the main portal vein (MPV) underwent RF ablation. Diagnosis of NPT was achieved by fine-needle biopsy. RF ablation was performed firstly on the NPT and then on the HCC. RF ablation was considered successful when complete necrosis of the HCC and complete recanalization of the MPV were achieved. HCC necrosis was evaluated using contrast-enhanced CT. Recanalization of the portal vessels (PV) was analyzed using Color Doppler (CD). RF ablation was performed under ultrasonographic (US) guidance using a perfused electrode needle.
  
  
  RESULTS
  Complete necrosis of the HCC with complete recanalization of the PV was observed in 7 patients (success rate: 70%). In the remaining 3, necrosis of the HCC ranged from 70% to 95%, and recanalization of the PV was not complete. No major complications occurred. In 2 cases, mild ascites and increased aspartate aminotransferase/alanine aminotransferase (AST/ALT) values were observed. The follow-up ranged from 4 to 24 months; 1 and 2-year survival rates were 77% and 77%, respectively. At the last follow-up, the 7 successful patients were alive and the portal system was still patent. The 3 unsuccessful patients died within 5 months due to progressive disease.
  
  
  CONCLUSIONS
  RF ablation can destroy HCC and NPT achieving a high rate of efficacy and low rate of complications. However, to confirm these results a control group and a longer follow-up are required.
authors: Infectious Diseases and Interventional Ultrasound Unit, D. Cotugno Hospital, Naples, Italy.
authors: A
authors: A
authors: Giorgio
authors: G
authors: G
authors: de Stefano
authors: A
authors: A
authors: Di Sarno
authors: N
authors: N
authors: Farella
authors: V
authors: V
authors: Giorgio
authors: U
authors: U
authors: Scognamiglio
authors: A
authors: A
authors: Mariniello
authors: G
authors: G
authors: Liorre
authors: A
authors: A
authors: Perrotta
authors: N
authors: N
authors: Mariniello
keywords: Cirrhosis; Hepatocellular carcinoma; Portal vein; Tumor thrombus
references: Radiology. 2000 Mar;214(3):761-8
references: 10715043
references: Cancer. 2006 May 1;106(9):1990-7
references: 16565970
references: Radiology. 2000 Oct;217(1):119-26
references: 11012432
references: Cancer. 1996 Jun 1;77(11):2217-22
references: 8635087
references: Radiology. 2008 Jul;248(1):288-96
references: 18483229
references: World J Gastroenterol. 2006 Dec 21;12(47):7561-7
references: 17171782
references: Hepatology. 1999 Jan;29(1):62-7
references: 9862851
references: AJR Am J Roentgenol. 2003 Aug;181(2):479-84
references: 12876030
references: Tumori. 1990 Aug 31;76(4):394-7
references: 2169081
references: Hepatology. 2005 Nov;42(5):1208-36
references: 16250051
references: AJR Am J Roentgenol. 2004 Nov;183(5):1319-26
references: 15505297
references: J Gastrointest Surg. 2006 Jun;10(6):855-62
references: 16769542
references: Surg Oncol Clin N Am. 2003 Jan;12(1):65-75, ix
references: 12735130
references: Ann Surg Oncol. 2006 Jul;13(7):940-6
references: 16788755
references: Anticancer Res. 2007 Nov-Dec;27(6C):4263-9
references: 18214030
references: J Hepatol. 2004 Sep;41(3):421-6
references: 15336445
references: Hepatogastroenterology. 2001 Sep-Oct;48(41):1421-4
references: 11677978
references: Eur J Ultrasound. 2000 Dec;12(2):145-54
references: 11118922
references: Surgery. 2005 Apr;137(4):403-10
references: 15800485
references: Hepatology. 2000 Aug;32(2):233-8
references: 10915729
references: J Hepatol. 2001 Sep;35(3):421-30
references: 11592607