Effective Treatment of Hepatocellular Carcinoma Less Than 5.6 cm by Simultaneous Radiofrequency Ablation Plus Percutaneous Ethanol Injection

Abstract

Hepatocellular carcinoma (HCC) of small size can be treated effectively by radiofrequency ablation (RFA), with decreased tumor ablation rates when tumor size enlarges. Percutaneous Ethanol injection (PEI) was suggested to increase the effectiveness of RFA. A retrospective analysis of HCC treated by simultaneous RFA plus PEI was performed. Between 2009 and 2011, 26 cases (18 males, 8 females) with 31 liver tumors between 2.5 and 5.6cm (mean 3.77cm) in size were treated by simultaneous RFA plus PEI. Computed tomography or magnetic resonance imaging and alpha-fetoprotein levels were used to evaluate the treatment efficacy Complete tumor ablation was achieved in all cases with a single ablation session. No major complication occurred. Within a follow-up period of 4.6 to 28.5 months, intra-hepatic recurrence was found in 13/26 patients (50%). No local recurrence after treatment was noted. Twenty-two of twenty-six patients (84.6%) were still alive at the end of 2011. With addition of PEI during RFA, HCC less than 5.6cm can be effectively ablated in a single ablation session.