Liver Cancer
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2005; 11(40): 6277-6280
Published online Oct 28, 2005. doi: 10.3748/wjg.v11.i40.6277
Percutaneous ethanol injection, radiofrequency and their combination in treatment of hepatocellular carcinoma
Bao-Ming Luo, Yan-Ling Wen, Hai-Yun Yang, Hui Zhi, Xiao-Yun Xiao, Bing Ou, Jing-Sheng Pan, Jian-Hong Ma
Bao-Ming Luo, Yan-Ling Wen, Hai-Yun Yang, Hui Zhi, Xiao-Yun Xiao, Bing Ou, Jing-Sheng Pan, Jian-Hong Ma, Department of Ultrasound, the Second Affiliated Hospital, Sun Yat-sen University, 107 Yanjiangxi Rd, Guangzhou 510120, Guangdong Province, China
Author contributions: All authors contributed equally to the work.
Supported by the Natural Science Foundation of Guangdong province of China No.31710 and the Medical Research Foundation of the Bureau of Health of Guangdong Province of China No.A2003203
Correspondence to: Dr. Yan-Ling Wen, Department of Ultrasound, the Second Affiliated Hospital, Sun Yet-Sen University, 107 Yanjiangxi Rd, Guangzhou 510120, Guangdong Province, China. yanlingwen20@hotmail.com
Telephone: +86-20-81332516
Received: July 5, 2005
Revised: July 12, 2005
Accepted: July 15, 2005
Published online: October 28, 2005
Abstract

AIM: To evaluate the therapeutic effect and the indication of percutaneous ethanol injection (PEI), radiofrequency ablation (RFA) and their combination in treatment of hepatocellular carcinoma (HCC).

METHODS: Two hundred and fifty-five patients with HCC received treatment of PEI, RFA or their combination. Group1 (< 3 cm in diameter, n=85) was treated with PEI, group2 (< 3 cm in diameter, n=153) with RFA. Group3 (>3 cm in diameter, n=86) was divided into two groups. Group 3a (n=34) was treated with RFA, while group 3b (n=52) was treated with RFA for 2 wk after transcatheter arterial chemoembolization or PEI. Contrast-enhanced sonography was performed for 61 patients before and after RFA. Liver function and serum alpha-fetoprotein (AFP) were measured for all patients. Changes of the lesions on ultrasound and contrast-enhanced CT/MRI were evaluated for assessing the therapeutic responses. The 1-, 2-, 3- and 5-year survival rates were recorded after treatment.

RESULTS: In group 1, the complete necrosis rate of lesions after 1 mo was 77.6% (66/85). The level of AFP declined conspicuously after 1 mo. The 1-, 2-, 3- and 5-year survival rate after treatment was 80.0% (52/65), 60.4% (32/53), 52.5% (21/40) and 33.3% (7/21), respectively. In group 2, the complete necrosis rate of lesions after 1 moh was 92.2% (141/153). The level of AFP decreased conspicuously after 1 mo. The 1-, 2-, 3- and 5-year survival rate after treatment was 94.6% (88/93), 73.2% (52/71), 63.5% (33/52) and 46.4% (13/28), respectively. In group 3a, the complete necrosis rate of lesions after 1 mo was 23.5% (8/34). AFP dropped down to the normal level in only one patient after 1 mo. The 1-, 2- and 3-year survival rate after treatment was 47.6% (10/21), 42.9% (6/14) and 27.3% (3/11), respectively. Only one patient was still alive after 5 years. In group 3b, the complete necrosis rate of lesions after 1 mo was 57.7% (30/52). The level of AFP decreased after 1 mo. The 1-, 2-, 3- and 5-year survival rate after treatment was 68.6% (24/35), 46.2% (12/26), 36.8% (7/19) and 27.3% (3/11), respectively.

CONCLUSION: The therapeutic effect of RFA on small HCC is better than that of PEI. Small HCC is the optimal indication of RFA. For recurrent HCC (diameter>3 cm), the combined treatment of RFA and PEI/ACE should be used.

Keywords: Hepatocellular carcinoma; Radiofrequency ablation; Percutaneous ethanol injection; Embolism; Therapeutic effect