Combined locoregional treatment of patients with hepatocellular carcinoma: State of the art

Figure 1 Treatment procedure. A: Hepatocellular carcinoma in SVIII (4.5 cm in size) confirmed on digital subtraction angiography; B: Radiofrequency ablation (RFA) electrode placed into the tumor under ultrasonography-guidance with ablation performed during balloon-occlusion (circle); C: Post-RFA digital subtraction angiography showing the central devascularized area with peripheral reactive hyperemia; D: Complete devascularization obtained with superselective Drug-eluting bead trans-arterial chemoembolization.

Figure 2 Complex lesion. A: Hepatocellular carcinoma in SV (5 cm in size), located on the intra-abdominal free-surface, adjacent to a gastrointestinal structure; B: Combined treatment allows obtaining a central safe necrosis with radiofrequency ablation (RFA); subsequent post-RFA trans-arterial chemoembolization was used to treat a peripheral portion of the tumor, obtaining a safe complete response.