Treatment of primary and recurrent small hepatocellular carcinoma with percutaneous radiofrequency ablation with or without hepatic artery and portal vein chemoembolization / 中国微创外科杂志

ABSTRACT

Objective To explore the value of percutaneous radiofrequency ablation (PRFA) with or without transcatheter hepatic artery and portal vein chemoembolization in the treatment of primary and recurrent small hepatocellular carcinoma. Methods Ultrasound-guided percutaneous radiofrequency ablation was adopted in the treatment of 11 cases of primary small hepatocellular carcinoma (≤5 cm) and 13 cases of recurrent small hepatocellular carcinoma (≤3 cm) from September 2001 to September 2004. Among them, a combined use of transcatheter hepatic artery and portal vein chemoembolization was conducted in 4 cases of primary hepatocellular carcinoma and 8 cases of recurrent hepatocellular carcinoma. Results Out of the 11 cases of primary small hepatocellular carcinoma, CT or MRI results showed a complete coagulation necrosis of lesion in all 6 cases in which tumors were not more than 3 cm in diameter and in 4 out of 5 cases in which tumors were between 3 cm and 5 cm in diameter, the 1-, 1.5- and 2-year cumulative survival rates being 100%, 85 71% and 68 57%, respectively. Out of the 13 cases of recurrent small hepatocellular carcinoma, CT or MRI results showed a complete coagulation necrosis in all 7 lesions in cases of solitary tumor and in 12 out of 15 lesions in 6 cases of multiple tumors, the 1-, 1.5- and 2-year cumulative survival rates being 88.89%, 77 78% and 64 81%, respectively. Conclusions Percutaneous radiofrequency ablation provides a new alternative for the treatment of primary and recurrent small hepatocellular carcinoma. For patients with tumor more than 3 cm in diameter or with recurrent hepatocellular carcinoma, a combined use of transcatheter hepatic artery and portal vein chemoembolization conduces to a high tumor necrosis rate, a decrease of recurrence and an elevation of survival rate.