Percutanous ablative therapy for HCC: a comparison of three modalities

ABSTRACT

This study was performed on 78 patients having liver cirrhosis with 91 focal hepatic lesions detected by ultrasound and proved histopathologically to be HCC [biopsy and/or fine needle aspiration cytology; FNAC]. They were 70 males and 8 females their ages ranged between 37 and 75 years old. Patients were classified into three groups, Group A was formed of 32 patients with 37 focal lesions where they received RFA. Group B encountered 25 patients with 26 focal lesions and they received PAI Group C included 21 patients with 28 focal lesions were treated by PEI. Complete ablation was assessed by re-biopsy and/or FNAC, triphasic CT and AFP serum level. As regards the outcome of therapy in group A, complete ablation was achieved in 14/18 [78%] for lesions techniques the overall success in group A was 71.4% while in group B it was 88.5% and 96.4% in group C. As regards the number of sessions in each group, the mean number of sessions was 2.2 +/- 0.75, 2.19 +/- 0.72 and 5.2 +/- 2.6 in group A, B and C, respectively. Major complications occurred in 4 patients of group A [second degree burn at the site of grounding pads, pneumothorax, malignant pleural effusion and hematemesis] and in one patient of group C [seedling]. Minor complications as pain, fever and ascites occurred in all groups, but it was more evident in group B. After the follow up of all patients the survival rate was 93 and 83% for group A, 85% and 78% for group B and 45.4%, 30% for group C patients at 1 year and 1.5 years, respectively. In conclusion, PEI, PAI and RFA are effective modalities for treatment of HCC; however PEI and PAI are cheaper, more effective and safer than RFA, however the survival was better in the RFA group