The combined effect of radiofrequency and ethanol ablation in the management of large hepatocellular carcinoma

Sakr, Ayman A.; Saleh, Alaa Ahmed; Moeaty, Amr Ali Abdel; Moeaty, Ali Abdel

doi:10.1016/j.ejrad.2004.06.008

« Previous Next »European Journal of Radiology
Volume 54, Issue 3 , Pages 418-425, June 2005

The combined effect of radiofrequency and ethanol ablation in the management of large hepatocellular carcinoma

Ayman A. Sakr
- Department of Radiation Sciences, Radiology Unit, Medical Research Institute, University of Alexandria, 165 Horreya Avenue, El Hadara, Alexandria, Egypt
- Corresponding author. Present Address: Department of Radiology, Almana General Hospital, P.O.Box 10366, Jubail 31961, Saudi Arabia. Tel.: +966 3 341 2000x1048 (Work +966 3 347 1377 Mobile +20 12 397 4123); fax: +966 3 341 7794.
Alaa Ahmed Saleh
- Department of Radiation Sciences, Radiology Unit, Medical Research Institute, University of Alexandria, 165 Horreya Avenue, El Hadara, Alexandria, Egypt
Amr Ali Abdel Moeaty
- Department of Internal Medicine, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
Ali Abdel Moeaty
- Department of Internal Medicine, Faculty of Medicine, University of Alexandria, Alexandria, Egypt

Received 4 December 2003; received in revised form 18 June 2004; accepted 25 June 2004.

Abstract

Only a small percentage of patients with large hepatocellular carcinoma (HCC) may benefit out of surgical resection. Thus, most of these patients are in need of a form of local control, such as ethanol ablation, transarterial chemoembolization (TACE), radiofrequency thermal ablation (RF), or laser induced thermotherapy (LITT). The purpose of this study was to assess the short-term effect of sequential RF and ethanol ablation in the management of large HCC (>5cm). Our series included 40 patients with large HCC tumors (>5cm in diameter). We adopted a protocol of overlapping RF applications, followed by repeated ethanol ablation sessions. Our results showed that the volume of tumor coagulative necrosis initially induced by RF has significantly risen after adjuvant ethanol ablation sessions (P < 0.001). Patients who achieved complete tumor necrosis after RF ablation were 52.5% of the series. This percent has jumped to 80% of the series at the end of the protocol. This indicates that such combined protocol is more effective than RF alone. Besides, it is valuable in reducing the number of RF sessions.