Efficacy and safety of intraoperative radio frequency ablation in management of hepatocellular carcinoma

ABSTRACT

The present study is a prospective one involving 15 consecutive patients with hepatocellular carcinoma [HCC] from January 2003 to December 2005. Clinical and laboratory examinations, abdominal ultrasonography and spiral CT scanning were performed. All patients were subjected to intraoperative radiofrequency ablation of HCC after confirmation by core biopsy. Enhanced dynamic CT was done at 1 month postoperative and every 3 months during follow-up period. Males were 12 with age of 41-69 year [53.2 +/- 7.4]. Underlying cirrhosis due to viral hepatitis was in all, and HCV was the most common [75%], and patients [85%] were categorized in Child B classification. Serum alpha feto protein was above 400 ng/ml in 60%. 12 patients had unifocal HCC [nodules mean diameter of less than 3 cm in 6, 3 to 5 cm in 4, and more than 5 cm in 2], and 3 patients had multifocal HCC [nodules mean number of less than 3 cm in 2 and 3 to 5 cm in 1]. The mean number of RF application session to achieve complete necrosis in patients with were 1.52 [unifocal] and 2.49 [multifocal HCC]. The mean hospital stay was 14.9 days, with neither mortality nor major complications, but Minor complications in 30%. After one month, complete ablation of HCC nodules was achieved in 10 patients with reduction of alpha fetoprotein in 11 patients. 2/5 with partial ablation were multifocal nodules. Total mortality during follow-up in late post-operative period [1 year] was 6 out of 15 patients. 5 of them are the patients with partial ablation. 3 patients out of 9 patients developed evidence of local recurrence detected by enhanced dynamic CT and raising of serum alpha fetoprotein