Solitary huge hepatocellular carcinomas 10 cm or larger may be completely ablated by repeated radiofrequency ablation combined with chemoembolization: Initial experience with 9 patients.

The treatment of solitary huge hepatocellular carcinoma (SHHCC) larger than 10 cm remains a challenge. The aim of the present study was to assess the therapeutic effects of repeated radiofrequency ablation (RFA) combined with chemoembolization on SHHCC. This was a retrospective study based on data obtained from a prospectively collected database that included 9 SHHCC patients who underwent repeated RFA combined with chemoembolization between July 2008 and June 2011. A new management strategy for SHHCC was described. The mean tumor size of the patients was 11.5 ± 1.0 cm. No technical failure occurred, no patient succumbed to the disease during this treatment and the median survival of all 9 patients was 34 months. Treatment of the 9 tumors required a mean of 8.2 ± 1.5 sessions. The mean of RF applications per session was 5.3 ± 0.9 and the mean time of one session was 165 ± 30 min, including a mean time of RF application of 113 ± 19 min. The SHHCCs were found to be completely ablated. The mean number of RFA for primary complete ablation was 7.0 ± 0.9 sessions, and the mean time for primary complete ablation was 5.3 ± 1.1 months. The overall survival rate was 100%. There were 4 actual 2-year survivors. Our data reveal that tactically and strategically performed RFA should be recommended to SHHCC patients who are not suitable or do not agree to surgery, with satisfactory efficacy and safety.