Clinical

Radiofrequency ablation decreases hepatocellular carcinoma recurrence

Last Updated: 2009-07-03 8:50:25 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Adjuvant percutaneous radiofrequency ablation (RFA) of the feeding artery of hypervascular hepatocellular carcinoma (HCC) before routine RFA of the tumor decreases the likelihood of recurrence, according to a report in the June 7th World Journal of Gastroenterology.

RFA appears to be less effective for hypervascular HCC because of a blood-flow-induced heat sink effect that can lead to incomplete ablation or recurrence, the authors explain.

Dr. Yi-Bin Hou and colleagues from Peking University School of Oncology, Beijing, hypothesized that if percutaneous ablation of the feeding artery (PAA) of HCC could block or reduce the blood flow of HCC, then the ablation volume of coagulation necrosis of subsequent RFA of the tumor would be increased.

To test their hypothesis, they randomly assigned 154 patients with hypervascular HCC to either routine RFA or PAA followed by RFA. In the PAA group, PAA effectively blocked the feeding artery in 66 of 75 lesions (88%) and decreased its size in the remaining 9 lesions (12%), the authors report.

The complete necrosis rates did not differ significantly with and without PAA, the investigators say, but the recurrence rate at 6 months was significantly lower after PAA followed by RFA (17.33%) than after RFA alone (31.37%).

Major complications occurred with similar frequency in the 2 groups, the report indicates, and all complications were managed conservatively.

"For hypervascular patients who were unsuitable for surgical resection or transcatheter arterial chemoembolization (TACE), PAA was an alternative for blocking the feeding artery of the tumor and reducing heat loss during subsequent RFA," the authors conclude. "The combination of PAA and RFA could significantly decrease post-RFA recurrence and provide a safe and effective treatment for hypervascular HCC."

World J Gastroenterol 2009;15:2638-2643.