Sonographically Guided Radiofrequency Ablation of Subcapsular Hepatocellular Carcinoma, MOHAMMED ZAKI and MEDHAT IBRAHEEM
Abstract
Background: Radiofrequency ablation is an important and ideal treatment for hepatocellular carcinoma. However; subcapsular HCC carcinoma need special care to be treated by radiofrequency ablation.
Objective: To evaluate the safety and effectiveness of percutaneous radiofrequency ablation (RFA) of subcapsular hepatocellular carcinoma (HCC).
Patients and Methods: We performed a retrospective analysis of 50 patients who underwent percutaneous ultra-sound-guided RFA for treatment of HCC in Sohag University Hospital from May 2008 to April 2014. All lesions are sub-capsular HCC (less than one cm from the capsule). All patients underwent contrast enhanced computed tomography imaging of the liver during follow-up and the treatment effectiveness and safety were evaluated. Incomplete ablation, recurrence, complications, and mortality were reported.
Results: Complete ablation was achieved in 45 out 50 patients. Four patients were referred to chemo-embolization treatment. The 5th patient was lost to follow-up. Five major complications occurred in our series, namely sub-capsular hematoma (in 2 patients), pleural effusion (in 2 patients), transient ascites (in 1 patient), portal vein branch thrombosis (in 1 patient) and needle track tumour seeding (in 1 patient). No death was reported in our study.
Conclusion: Subcapsular HCC carcinoma can be treated safely and effectively by RFA using cautious techniques by experienced operators to prevent complications.