Therapy of HCC-radiofrequency ablation

Radiofrequency interstitial hyperthermia has been used for percutaneous abl ation of hepatocellular carcinoma, under ultrasound guidance in local anest hesia. Conventional needle electrodes require a mean number of 3 sessions t o treat tumors of diameter less than or equal to 3cm. Tumors up to 3.5cm in diameter can be treated in 1 or 2 sessions by expandable needle electrodes . With both methods in all treated cases, ablation of tumors was obtained. In a group of patients with long follow-up, survival rate at 5 years was 40 %. In a mean follow-up of 23 months 41% of patients had recurrences (local recurrences in 5%; new lesions in 36%), which often could be retreated by a new course of radiofrequency application. In recent experience large hepat ocellular carcinomas (up to 6.8cm in diameter) were treated by a combinatio n of segmental transcatheter arterial embolization followed by radiofrequen cy application. In this way most tumors were ablated in one session of radi ofrequency therapy. No fatal complications were observed. Major complications were: strong pain due to capsular necrosis in one patient; hemotorax in one case; a fluid co llection in the site of ablated tumor in one patient treated by combination of transcatheter arterial embolization and radiofrequency application.