Efficacy and safety of intraoperative radiofrequency ablation in management of hepatocellular carcinoma

الملخص EN

The present study is a prospective one involving 15 consecutive patients with hepatocellular carcinoma (HCC) from January 2003 to December 2005.

Clinical and laboratory examinations, abdominal ultrasonography & spiral CT scanning were performed.

All patients were subjected to intraoperative radiofrequency ablation of HCC after confirmation by core biopsy.

Enhanced dynamic CT was done at 1 month postoperative and every 3 months during follow-up period.

Males were 12 with age of 41-69 year (53.2 + 7.4).

Underlying cirrhosis due to viral hepatitis was in all, and HCV was the most common (75 %), and patients (85 %) were categorized in Child B classification.

Serum alpha feto protein was above 400 ng / ml in 60 %.

12 patients had unifocal HCC (nodules mean diameter of less than 3 cm in 6, 3 to 5 cm in 4, and more than 5 cm in 2), and 3 patients had multifocal HCC (nodules mean number of less than 3 cm in 2 and 3 to 5 cm in 1).

The mean number of RF application session to achieve complete necrosis in patients with were 1.52 (unifocal) & 2.49 (multifocal HCC).

The mean hospital stay was 14.9 days, with neither mortality nor major complications, but Minor complications in 30 %.

After one month, complete ablation of HCC nodules was achieved in 10 patients with reduction of alpha fetoprotein in 11 patients.

2 / 5 with partial ablation were multifocal nodules.

Total mortality during follow-up in late post-operative period (1 year) was 6 out of 15 patients.

5 of them are the patients with partial ablation.

3 patients out of 9 patients developed evidence of local recurrence detected by enhanced dynamic CT & raising of serum alpha fetoprotein.