Haruyuki Takaki MD, Presenter: Nothing to Disclose

Koichiro Yamakado MD, Abstract Co-Author: Nothing to Disclose

Junji Uraki MD, Abstract Co-Author: Nothing to Disclose

Atsuhiro Nakatsuka MD, Abstract Co-Author: Nothing to Disclose

Kan Takeda MD, Abstract Co-Author: Nothing to Disclose

This study was undertaken to evaluate whether radiofrequency (RF) ablation combined with chemoembolization is a useful therapeutic option for the treatment of recurrent hepatocellular carcinomas (HCCs) following hepatectomy.

Patients who met the following criterion received RF ablation: 1) patients having recurrent HCC tumors following hepatectomy, 2) 5 or less tumors measuring 5cm or less in a maximum diameter, 3) Child-Pugh grade A or B, 4) No extrahepatic spread. RF ablation was done under the CT fluoroscopic guidance 1-2 weeks after chemoembolization. Technical success was defined as an appearance of non-enhacing area surrounding an ablated HCC nodule on contrast-enhanced CT images obtained 1 week after RF ablation. The primary and the secondary endpoints were overall and recurrence-free survivals.

Thirty-two patients with 48 recurrent tumors were included in the study. The mean maximum tumor size was 2.4cm (range, 1.0-4.8 cm). Technical success was achieved in all 32 patients (100%). Local tumor progression was found in 3 patients (9%, 3/32), and new tumors emerged in the untreated liver in 12 patients (38%, 12/32) during the mean follow-up of 28 months (range, 3-72 months). The estimated overall survival rates after RF ablation were 96%, 83%, and 59% at 1, 3, and 5 years, respectively. The estimated recurrence-free survival rates were 79%, 53%, and 43% at 1, 3, and 5 years, respectively. The interval between hepatectomy and intrahepatic recurrence was a significant factor affecting recurrence-free survival. The recurrence-free survival was significantly better in 25 patients with delayed recurrence (over 1 year after hepatectomy) than in 7 patients with early recurrence (within 1 year after hepatectomy) (81% and 69% at 1 year, p < 0.05).

This combined therapy is feasible and effective therapeutic option to improve survival in patients with recurrent HCCs following hepatectomy. The interval between hepatectomy is a significant factor for tumor-free survival after RF ablation.

Combined use of RF anlation and chemoembolization is feasible and effective therapeutic option to improve survival in patients with recurrent HCCs following hepatectomy.

Takaki, H, Yamakado, K, Uraki, J, Nakatsuka, A, Takeda, K, RF Ablation Combined with Chemoembolization for the Treatment of Recurrent Hepatocelluler Carcinomas Following Hepatectomy.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5011247.html