Small hepatocellular carcinoma: Treatment with radio-frequency ablation versus ethanol injection

PURPOSE: To compare the effectiveness of radio-frequency (RF) ablation with that of percutaneous ethanol injection in the treatment of small hepatocel lular carcinoma (HCC). MATERIALS AND METHODS: Eighty-six patients with 112 small (less than or equ al to 3-cm-diameter) HCCs underwent RF ablation (42 patients with 52 tumors ) or percutaneous ethanol injection (44 patients with 60 tumors). Therapeut ic efficacy was evaluated with dual-phase spiral computed tomography perfor med at least 4 months after treatment. RESULTS: Complete necrosis was achieved in 47 of 52 tumors with RF ablation (90%) and in 48 of 60 tumors with percutaneous ethanol injection (80%). Th ese results were obtained with an average of 1.2 sessions per tumor with RF ablation and 4.8 sessions per tumor with percutaneous ethanol injection. O ne major complication (hemothorax that required drainage) and four minor co mplications (intraperitoneal bleeding, hemobilia, pleural effusion, cholecy stitis) occurred in patients treated with RF ablation; no complications occ urred in patients treated with percutaneous ethanol injection. CONCLUSION: RF ablation results in a higher rate of complete necrosis and r equires fewer treatment sessions than percutaneous ethanol injection. Howev er, the complication rate is higher with RF ablation than with percutaneous ethanol injection. RF ablation is the treatment of choice for most patient s with HCC.