Minhua Chen, Presenter: Nothing to Disclose

Wei Yang MD, Abstract Co-Author: Nothing to Disclose

Wei Wu MD, Abstract Co-Author: Nothing to Disclose

Kun Yan BS, Abstract Co-Author: Nothing to Disclose

Jin Yu Wu BS, Abstract Co-Author: Nothing to Disclose

Wen Gao BS, Abstract Co-Author: Nothing to Disclose

to investigate the treatment strategy and outcome of RFA of >3.5 cm HCC.

172 patients who had 176 >3.5cm HCC and were not candidate for surgery or TACE were enrolled in this study. There were 142 males and 30 females (mean age of 60.3 10.4 years, ranged from 24-84 years). The average tumor size was 4.7±0.9 cm in diameter ( ranged from 3.6-7.0 cm). The size of 108 tumors were 3.6-5.0cm, while the remaining 68 tumors 5.1-7.0cm.Established strategy : (1) multiple overlapping ablations based on mathematical protocol; (2) color US guided percutaneous ablation of tumor feeding artery (PAA) + RFA for HCC with rich supply; (3) percuteneous arterial embolization + RFA for HCC with high velocity flow. 

The ablation success rate was 91.5 % (161/176 tumors) for all patients, 93.5% (101/108 tumors) for 3.6-5.0 cm HCC and 88.2% (60/68 tumors) for 5.1-7.0cm HCC, respectively. Follow-up period ranged from 3 to 86 months with average 26 months. The local recurrence rate was 17.6% (31/176 tumors) and intrahepatic new occurrence rate was 41.3% (71/172 cases). The 1-, 3-, 5- overall survival were 80.4%, 52.0% and 37.5% for all patients, were 81.5%, 57.5% and 46.5% for 3.6-5.0cm HCC patients and were 80.1%, 43.9% and 25.4% for 5.1-7.0cm HCC patients, respectively (P=0.174). The incidence of major complications was 3.5 % (6/172 cases), including intraperitoneal hemorrhage (n = 2), hemothorax (n = 1), bowel perforation (n=1) and needle tract seeding (n = 2). Of these, only one patient suffered from colon perforation one week after RFA treatment required surgical intervention.

The protocol presented in this study for tumor >3.5 cm can achieve a high success rate with a low local recurrence rate, and then benefit for survival.  But the patients with >5 cm HCC tended have lower survival than 3.5-5.0 HCC patients, thus optimized multi-modalities treatment should be investigated for these tumors in the future.

The protocol presented in this study for tumor >3.5 cm can achieve a high success rate with a low local recurrence rate, and then benefit for survival.

Chen, M, Yang, W, Wu, W, Yan, K, Wu, J, Gao, W, Treatment Strategy and Efficacy of Radiofrequency Ablation in 172 Patients with >3.5cm Hepatocellular Carcinoma.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/7106872.html