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[Percutaneous radiofrequency ablation combined with transcatheter arterial chemoembolization for hepatocellular
Zhijian Zhang1, Mengchao Wu, Han Chen
1Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
Objective:
To assess the significance of the method of percutaneous radiofrequency ablation (PRFA) combined with transcatheter arterial chemoembolization for hepatocellular carcinoma.
Methods:
Thirty patients with hepatocellular carcinoma were divided into PRFA group and TACE + PRFA group between January 2000 and July 2001. All patients were followed up to examine the value of AFP, MRI or CT. Kaplan-Meier estimation was used for the analysis of disease-free survival and the cumulative survival rate.
Results:
The complete necrosis rates were 86.7% (13/15) and 26.7% (4/15) in the TACE + PRFA group and group PRFA group respectively. The rates of AFP positive down to negative were 66.7% (6/9) for the former and 20% (2/10) for of the latter, and the six-month disease-free survival rates were 100% (13/13) and 75% (3/4) in the two groups. The 1-, 1.5- and 2-year survival rates of the group TACE + PRFA were 100%, 100% and 66.7% respectively. The survival rates of 1 and 1.5 years of the group PRFA only were 80% and 40%.
Conclusions:
For those hepatocellular carcinomas over 3 cm in size, located in the porta hepatis, or with indistinct boundary or the presence of foci, TACE can be performed first and then followed by PRFA in suitable time. This method can enlarge the necrosis range and increase the rate of complete necrosis of tumors, thereby decrease the recurrence and improve the disease-free survival and total survival of patients.