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

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%) werecategorized 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.