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World J Gastroenterol. Feb 21, 2006; 12(7): 1098-1104
Published online Feb 21, 2006. doi: 10.3748/wjg.v12.i7.1098
Therapeutic effectiveness of echo-guided percutaneous radiofrequency ablation therapy with a LeVeen needle electrode in hepatocellular carcinoma
Luigi Solmi, Giovanni Nigro, Enrico Roda
Luigi Solmi, Giovanni Nigro, Enrico Roda, Gastroenterological Unit, Polyclinic Hospital Sant’Orsola-Malpighi, University School of Medicine, Bologna, Italy
Correspondence to: Luigi Solmi, M.D., Unità Operativa di Gastroenterologia, Policlinico Sant’Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy. solmil@aosp.bo.it
Telephone: +51-6362509-308 Fax: +51-300700
Received: June 16, 2005
Revised: July 2, 2005
Accepted: August 26, 2005
Published online: February 21, 2006

AIM: To investigate the results of radiofrequency ablation (RFA) in obtaining the necrosis of hepatocellular carcinoma (HCC) in cirrhotic patients and to assess the results of RFA in relation to recurrence of HCC and survival of the treated patients.

METHODS: Fifty-six consecutive cirrhotic patients with 63 HCCs were treated with RFA between May 2000 and May 2004. The diameter of the HCCs ranged from 1 cm to 5 cm (mean 2.8 cm). In all cases RFA was performed with percutaneous approach under ultrasound guidance using expandable needle electrode (LeVeen needle). Treatment efficacy and recurrence were evaluated with dual-phase spiral computed tomography (CT).

RESULTS: Complete necrosis after single or multiple treatment was achieved in 96.8% (61/63) tumors. We observed recurrence after complete necrosis in 23 patients (41%) during a mean follow-up of 32.3 months. The recurrences were local in 2 patients (8.6%) and in different segments in 21 (91.4%). Major complications occurred in 3 patients (4%). During follow-up period, 32 (57.1%) patients died; 15 due to progression of HCC, 11 from liver failure, 3 from esophageal varices bleeding and 3 from the causes not related to liver disease.

CONCLUSION: RFA with LeVeen needle is an effective and safe treatment for HCC < 5 cm in cirrhotic patients. It has yet to be established how far this treatment influences the survival rate of patients. It becomes important to establish treatments to prevent recurrences in different segments, such as interferon therapy.

Keywords: Hepatocellular carcinoma, Radiofrequency ablation, Complication, Recurrence