PERCUTANEOUS TREATMENT OF SMALL HEPATIC-TUMORS BY AN EXPANDABLE RF NEEDLE ELECTRODE

OBJECTIVE, The aim of this study was to evaluate the usefulness of exp andable RF needle electrodes in the treatment of hepatic cancer. SUBJE CTS AND METHODS, Thirty-seven patients, 23 of whom had 26 hepatocellul ar carcinoma nodules and 14 of whom had 19 hepatic metastatic nodules, underwent treatment by RF interstitial thermal ablation with expandab le needle electrodes. Forty-five tumor nodules were treated in 64 RF i nterstitial thermal ablation sessions with 83 needle electrode inserti ons, The mean diameter of the tumor nodules was 2.5 cm (range, 1.1-3.5 cm). Immediate posttreatment tumor necrosis was evaluated by dynamic CT in all cases. Two patients with hepatocellular carcinoma and three patients with metastases underwent surgical resection 20-60 days after RF treatment. The remaining 32 patients were followed up clinically. RESULTS. The mean number of RF interstitial thermal ablation sessions to complete tumor nodule treatment was 1.4, Mean number of needle elec trode insertions was 1.8. No complications were observed. Posttreatmen t dynamic CT showed a completely nonenhancing area in the site of the treated tumor in 44 of 45 cases. The remaining patient with metastatic disease had persistent enhancing tissue. Histology showed complete ne crosis in four treated tumor nodules and residual viable cancer in one . Twenty-one patients with hepatocellular carcinoma were followed up f or 6-19 months (mean, 10 months). Of these patients, six showed recurr ences and 15 remained apparently disease-free. Two patients died, one from advanced cancer and one from other causes. Eleven patients with h epatic metastases were followed up for 7-20 months (mean, 12 months). Of these patients, nine showed recurrent disease and only two remained apparently disease-free. Two patients died from disseminated disease, CONCLUSION. RF interstitial thermal ablation of hepatic tumor by expa ndable needle electrodes is a safe and effective technique. Local abla tion of tumors not exceeding 3.5 cm in diameter is achieved in a short time without complications.