OBJECTIVE: To evaluate the efficacy and safety of combined radiofrequency ablation (RFA) and ethanol injection with a multipronged needle in the treatment of medium (3.1-5.0 cm) and large (5.1-7.0 cm) hepatocellular carcinoma (HCC). METHODS: A total of 65 patients with 67 HCC nodules were enrolled in this prospective study. All of them received the treatment of combined RFA and multipronged ethanol injection percutaneously. RESULTS: The average volume of injected ethanol was 14.4 ± 4.1 ml (range, 9-30 ml). The average number of RFA electrode insertions was 1.7 ± 0.8 (range, 1-4). The rate of initial local complete response (CR) was 94.0 % (63/67). After additional treatment, technical success was achieved in all HCC nodules. There were no treatment-related deaths, and major complications were observed in 3 (4.6%) patients. After a mean follow-up of 20.0 ± 7.6 months, local tumour progression was observed in 10 (10/67, 14.9%) tumours, whereas distant recurrence developed in 32 (32/65, 49.2%) patients. The 1-year and 2-year survival rates were 93.1% and 88.1%, respectively. CONCLUSION: The combination of RFA and multipronged ethanol injection in the treatment of medium and large HCC is safe and effective with a high rate of local tumour control. KEY POINTS: • Combined radiofrequency ablation and multipronged ethanol injection is a new therapeutic strategy • Treatment is safe and effective for medium and large hepatocellular carcinoma (HCC) • A multipronged needle allows for a homogeneous ethanol distribution.
OBJECTIVE: To evaluate the efficacy and safety of combined radiofrequency ablation (RFA) and ethanol injection with a multipronged needle in the treatment of medium (3.1-5.0 cm) and large (5.1-7.0 cm) hepatocellular carcinoma (HCC). METHODS: A total of 65 patients with 67 HCC nodules were enrolled in this prospective study. All of them received the treatment of combined RFA and multipronged ethanol injection percutaneously. RESULTS: The average volume of injected ethanol was 14.4 ± 4.1 ml (range, 9-30 ml). The average number of RFA electrode insertions was 1.7 ± 0.8 (range, 1-4). The rate of initial local complete response (CR) was 94.0 % (63/67). After additional treatment, technical success was achieved in all HCC nodules. There were no treatment-related deaths, and major complications were observed in 3 (4.6%) patients. After a mean follow-up of 20.0 ± 7.6 months, local tumour progression was observed in 10 (10/67, 14.9%) tumours, whereas distant recurrence developed in 32 (32/65, 49.2%) patients. The 1-year and 2-year survival rates were 93.1% and 88.1%, respectively. CONCLUSION: The combination of RFA and multipronged ethanol injection in the treatment of medium and large HCC is safe and effective with a high rate of local tumour control. KEY POINTS: • Combined radiofrequency ablation and multipronged ethanol injection is a new therapeutic strategy • Treatment is safe and effective for medium and large hepatocellular carcinoma (HCC) • A multipronged needle allows for a homogeneous ethanol distribution.
Authors: S Nahum Goldberg; Clement J Grassi; John F Cardella; J William Charboneau; Gerald D Dodd; Damian E Dupuy; Debra Gervais; Alice R Gillams; Robert A Kane; Fred T Lee; Tito Livraghi; John McGahan; David A Phillips; Hyunchul Rhim; Stuart G Silverman Journal: Radiology Date: 2005-04-21 Impact factor: 11.105