The team investigated the use of radiofrequency thermal ablation (RFTA) in the treatment of recurrent hepatocellular carcinoma (HCC).
They reported their findings in the October issue of the Journal of Hepato-Biliary-Pancreatic Surgery.
The treatment of choice for hepatocellular carcinoma is surgical resection. However, recurrence occurs in most patients.
Aggressive treatment of liver recurrence increases patients' survival, but most frequently, these patients are not suitable for surgery.
A total of 79 patients with HCC were treated by RFTA (17 during laparotomy, 1 in video-laparoscopic surgery, and 61 percutaneously).
Of these patients, 5 had recurrences after surgical resection and 1 patient had a recurrence (new lesion) after percutaneous RFTA.
Some 15 of the 79 patients were treated for recurrence after transarterial chemoembolization (TACE). For the remaining 58 patients, RFTA was the first treatment.
The researchers used a radiofrequency generator with an expandable needle with 4, 7, or 9 hooks at its end.
| Lesions not completely treated by TACE can benefit from RFTA.
| Journal of Hepato-Biliary-Pancreatic Surgery |
All patients were followed up with enhanced computed tomography (CT) scans and alpha-fetoprotein sampling 1 month after RFTA, and then every 4 months.
All 5 patients treated for recurrence after resection were alive, after a mean period of 43 months from liver resection.
One patient was disease-free, 1 patient had controlled disease, and 3 patients were in progression.
The patient treated for recurrence after RFTA was disease-free after 4 months.
Author Nicola Nicoli, of the University of Verona, said on behalf of her colleagues, "We treated all our patients with intrahepatic recurrence after surgical resection by a multimodal approach.
"We regard RFTA as the treatment of first choice in the management of intrahepatic recurrence.
"However, for superficial tumors, surgical resection is still the best treatment, and for multifocal recurrence, TACE is needed."
"RFTA can be useful as a complementary technique for lesions not completely treated by TACE," she concluded.