Hepatocellular carcinoma: Radio-frequency ablation of medium and large lesions

PURPOSE: To study local therapeutic efficacy, side effects, and complicatio ns of radiofrequency (RF) ablation in the treatment of medium and large hep atocellular carcinoma (HCC) lesions in patients with cirrhosis or chronic h epatitis. MATERIALS AND METHODS: One-hundred fourteen patients who were under conscio us sedation or general anesthesia had 126 HCCs greater than 3.0 cm in diame ter treated with RF by using an internally cooled electrode. Eighty tumors were medium (3.1-5.0 cm), and 46 were large (5.1-9.5 cm). The mean diameter for all tumors was 5.4 cm. At imaging, 75 tumors were considered noninfilt rating, and 51 were considered infiltrating. RESULTS: Complete necrosis was attained in 60 lesions (47.6%), nearly compl ete (90%-99%) necrosis in 40 lesions (31.7%), and partial (50%-89%) necrosi s in the remaining 26 lesions (20.6%). Medium and/or noninfiltrating tumors were treated successfully significantly more often than large and/or infil trating tumors. Two major complications (death, hemorrhage requiring laparo tomy) and five minor complications (self-limited hemorrhage, persistent pai n) were observed. The single death was due to a break in sterile technique rather than to the RF procedure itself. CONCLUSION: RF ablation appears to be an effective, safe, and relatively si mple procedure for the treatment of medium and large HCCs.