Hepatocellular Carcinoma In Cirrhotic Patients. Our Experience With Echo-Guided Radiofrequency Percutaneous Ablation

Hepatic resection and orthotopic liver transplantation are the most effective therapy for hepatocellular carcinoma (HCC) in cirrhotic patients. In patients not suitable for surgery, many alternative procedures are today utilized. Aim of this study is to verify the therapeutical effectiveness of radiofrequency interstitial thermal ablation (RITA). From January 1995 to December 1998, 78 cirrhotic patients affected by HCC were observed in our Institution. Seven (8.9%) of them have been submitted to RITA, in the last year. All the patients were males and aged from 60 to 76 years (mean age 68.4). Four patients (57.1%) were classified as Child B and 3 (32.9%) as Child A, all had a single nodule variable from 2 to 5 cm in size, diagnosed by US, echo-color-doppler and CT scan. The indications for RITA were :general contraindications to surgery (3 cases), not given consensus for surgery (4 cases). Percutaneous "one-shot" RITA was performed under general anesthesia. In all patients thermal injuries were usually applied for 25 min. No intra or postoperative complications were observed, and the patients were discharged after 24-48 hours. The effectiveness of treatment was assesed at 20 days, 3, 6 and 9 months with CT scan. Complete disappearance of the lesion was achieved in in 3 patients (42.8%) in the remaining patients partial response was obteined. RITA seem to be a safe and effective alternative treatment in patients affected by HCC. Further investigations and major number of patients should be rquested for controlled trials in order to define the therapeutic role of this method.