Radiofrequency ablation of primary and metastatic hepatic malignancies

The majority of patients with primary of metastatic hepatic tumors are not candidates for resection, because of tumor size, location near major intrahepatic blood vessels precluding a margin-negative resection, multifocality, or inadequate hepatic function related to coexistent cirrhosis. Radiofrequency ablation (RFA) is an evolving technology being used to treat patients with unresectable primary and metastatic hepatic cancers. RFA produces coagulative necrosis of the tumor through local tissue heating. Liver tumors are treated percutaneously, laparoscopioally, or during laparotomy, using ultrasonography to identify tumors and to guide placement of the RFA needle electrode. For tumors smaller than 2.0 cm in diameter, one or two deployments of the monopolar multiple-array needle electrode are sufficient to produce complete coagulative necrosis of the tumor. However, with increasing size of the tumor, there is a concomitant increase in the number of deployments of the needle electrode and the overall time necessary to produce complete coagulative necrosis of the tumor. In general, RFA is a safe, well-tolerated, effective treatment for unresectable hepatic malignancies less than 6.0 cm in diameter. Effective treatment of larger tumors awaits the development of more powerful, larger array monopolar and bipolar RFA technologies. Received: January 7, 2002     

Radiofrequency ablation in patients with primary breast carcinoma: a pilot study in 26 patients

BACKGROUND: The authors performed a pilot trial of ultrasound-guided percutaneous radiofrequency ablation (RFA) in patients with T1 and T2 breast tumors 1) to confirm complete coagulative necrosis of tumor tissue and 2) to determine the safety and complications related to this treatment. METHODS: Twenty-six patients with biopsy-proven, invasive breast carcinoma underwent RFA of their breast tumors followed by immediate resection. Treatment was planned to ablate the tumor and a 5 mm margin of surrounding breast tissue. Tumor viability after RFA was assessed by hematoxylin and eosin and nicotinamide adenine dinucleotide vital staining. RESULTS: Twenty patients (77%) had T1 tumors, and six patients (23%) had T2 tumors. The mean greatest dimension of tumors that were treated with RFA was 1.8 cm (range, 0.7-3.0 cm). The mean treatment time for two-phase RFA treatment was 15 minutes and 23 seconds (range, from 6 minutes and 25 seconds to 24 minutes and 54 seconds). Coagulation necrosis of the tumor was complete in 25 of 26 patients (96%): One patient had a microscopic focus of viable tissue adjacent to the needle shaft site. A single patient (1 of 26 patients; 4%) had a complication related to RFA: a full thickness burn of the skin overlying a tumor that was immediately beneath the skin. CONCLUSIONS: This pilot experience with RFA in the treatment of patients with early-stage, primary breast carcinoma revealed that 1) coagulative necrosis of the entire tumor occurred in 96% of the patients, and 2) the treatment was safe, with only a 4% complication rate. The authors have initiated a trial of RFA alone (no resection) for patients with T1 and T2 breast tumors that will include sentinel lymph node mapping and postablation irradiation.     

Transdiaphragmatic radiofrequency ablation of malignant liver tumors

The majority of patients with primary or metastatic liver tumors are not candidates for resection because of the size, location, or multifocality of their tumors, or because of inadequate hepatic function related to cirrhosis. Radiofrequency ablation (RFA) is an evolving technique for treating patients with unresectable primary or metastatic liver cancers. After obtaining the approval of our institutional review board for this study, 12 patients with HCC and 6 patients with metastatic liver tumors were treated using the LeVeen RF ablation system at the Department of Surgery of Osaka National Hospital between March 2000 and February 2002. Informed consent was obtained from all patients. Ultrasound-guided RFA was done during open surgery. In 12 patients, RFA was performed during laparotomy, while in 6 patients it was done transdiaphragmatically during thoracotomy. All treated tumors showed complete necrosis on imaging after the completion of RFA. After a median follow-up period of 288 days, the tumor had recurred in 5 out of 18 patients, and the median overall survival rate was 362 days. No deaths or major complications occurred in these 18 patients. Liver function tests (ALT, AST, GGT) that were elevated after RFA returned to baseline in most patients by day 7. In 5 patients who underwent RFA at laparotomy, bile leakage and liver abscess developed. There were no cases of bile duct injury or liver abscess in the patients receiving transdiaphragmatic RFA. In conclusion, transdiaphragmatic RFA during thoracotomy is a safe, well-tolerated, effective treatment for unresectable hepatic malignancies.     

Radiofrequency ablation for hepatocellular carcinoma and liver metastases

We evaluated the efficacy of radiofrequency ablation (RFA) therapy for 29 patients with 36 hepatocellular carcinoma (HCC) nodules and 16 patients with 38 metastatic hepatic nodules. The mean tumor size was 26.4 mm. The primary lesions of patients with metastatic liver tumors were 9 colon cancer, 2 rectal cancer, 2 breast cancer, 2 gastric cancer, and 1 esophageal cancer. All nodules were treated using a Cool-tip RFA system. US-guided RFA was performed for 44 nodules, CT-guided RFA for 24 nodules, and intra-operative US-guided RFA for 6 nodules. In a mean observation period of 13.5 months, the mean complete ablation rate and the mean distant recurrence rate were 83.3% and 30.6% for HCC and 65.8% and 31.6% for metastatic nodules, respectively. The mean complete ablation rate of HCC was significantly higher than that of metastatic nodules (p < 0.05). The mean complete ablation rates of both HCC and metastatic hepatic nodules 3 cm or smaller in diameter were significantly higher than those of both tumors larger than 3 cm in diameter (p < 0.05). The mean distant recurrence rate of HCC in patients who have multiple nodules was 62.5% and it was significantly higher than that in patients who have a single nodule (28.6%) (p < 0.05). The mean complete ablation rate of metastatic nodules by intra-operative US guided RFA was 100% and it was statistically higher than that by other image guided RFA (p < 0.05).     

活体猪肝第一,二肝门区的单极灌注式射频消融的安全性观察

背景与目的:肿瘤在累及肝门区域时,外科切除的难度大,肿瘤易复发.射频消融作为一种成熟的方法在累及肝门区肿瘤治疗中是否具有更大优势.是临床关注的问题.本实验观察单极射频消融时间与消融范围的相关性;对第一和第二肝门区组织消融处理,了解消融对血管及胆管系统的影响及其病理改变.方法:选用健康家猪6只,体重(47.0±2.5)ks/只.常规麻醉,开腹,在每一肝脏实质内共确定3个位点进行射频消融,射频消融基础功率设定为60 W,时间分别为3 min、5 min、10 min.对第二肝门的部位和第一肝门的位置分别进行5 min和10 min射频消融处理,然后关闭腹部伤口,继续饲养7～10天,将猪放血处死,完整取出肝脏.结果:大体标本上不同时间产生的结果为组织消融范围不同,均呈椭圆型.3 min、5 min、10 min消融时间产生坏死区长径分别为(2.7±0.2)cm、(4.6±1.1)cm、(5.8±0.7)cm;在大体标本上第一和第二肝门区消融坏死范围宽径分别为(3.2±1.1)cm、(3.3±0.4)cm,第一肝门区和第二肝门区血管壁、胆管系统未见有明确破坏,病理结果显示血管壁和胆管壁有炎症细胞浸润.第二肝门区消融,病理结果显示:5只邻近血管壁的消融区域完全坏死,1只显示在邻近血管壁正常肝组织中合并有大片状坏死.第一肝门区消融结果,病理分析消融中心部位肝且织完全坏死,4只邻近血管壁的消融区域完全坏死,2只显示在邻近血管壁正常肝组织中合并有大片状坏死.结论:射频消融时间影响消融组织的坏死范围.消融对门静脉、肝动脉、肝门区胆管系统影响较少,在肝门区组织中实行消融是安全的.     

规范化射频消融治疗肝脏肿瘤

目的 探讨规范化射频消融治疗肝脏肿瘤的疗效、适应证、并发症和治疗规范.方法 严格按照术前评估、术中完全损毁和术后即时评价的规范化操作程序,对421例肝脏肿瘤患者进行冷循环射频消融治疗,共634处病灶,行射频消融1121次.结果 全组421例患者无术中死亡.全部634处病灶中有514处完全消融,占81.1%.其中最大径＜3 cm病灶的完全消融率为91.4%(382/418),3～5 cm病灶为78.9%(97/123),>5 cm病灶为37.6%(35/93).术后有147例(34.9%)出现一过性发热,136例(32.3%)出现腹痛,38例(9.0%)出现恶心,12例(2.9%)出现胸腔积液,2例(0.5%)出现肝脓肿,1例(0.2%)出现胆漏.结论 规范化射频消融治疗肝脏肿瘤效果确切,无严重并发症发生.     

超声引导射频消融治疗肝脏恶性肿瘤302例肿瘤残留危险因素分析

背景与目的：射频消融(radiofrequencey ablation,RFA)是治疗原发性肝癌和部分转移性肝癌的有效的方法,本研究探讨肝脏恶性肿瘤RFA治疗后肿瘤残留的危险因素。方法：回顾性分析2010年1月-2013年3月复旦大学附属肿瘤医院收治的302例原发性肝癌和转移性肝癌患者共691个肝内病灶接受RFA治疗的临床资料,采用单因素和多因素Logistic Regression模型分析与RFA治疗后肿瘤残留有关的危险因素。结果：RFA治疗后272例(90.07%)患者的632个(91.46%)病灶完全消融,肿瘤残留率为8.54%。直径≤3 cm的肿瘤残留率为6.30%,3~5 cm为9.57%,>5 cm为28.57%;靠近肝内大血管和胆囊肿瘤残留率分别为17.14%和18.52%;联合其他局部治疗和未联合其他局部治疗的肿瘤残留率分别为7.02%和13.41%。多因素分析显示,肿瘤最大直径>5 cm(P=0.044)、靠近肝内大血管(P=0.039)和未联合其他局部治疗(P=0.001)是RFA治疗后肿瘤残留的独立危险因素。112例患者282个病灶最大直径3~5 cm,RFA治疗后肿瘤残留多因素分析显示,肿瘤靠近肝内大血管(P=0.014)、单针射频(P=0.047)和未联合其他局部治疗(P=0.023)是RFA治疗后肿瘤残留的独立危险因素。结论：超声引导的RFA治疗可以获得满意的消融效果,其中肿瘤靠近肝内大血管、肿瘤最大直径>5 cm和未联合其他局部治疗是肿瘤残留的独立危险因素,对于直径为3~5 cm的肿瘤,除靠近肝内大血管和未联合其他局部治疗外,单针射频也是肿瘤残留的独立危险因素,采用双针或多针治疗可以提高消融效率,降低肿瘤残留。     

Radiofrequency ablation: a minimally invasive technique with multiple applications

PURPOSE: Radiofrequency ablation (RFA) of soft tissue, which has recently been approved by the United States Food and Drug Administration, destroys tumor cells by delivering an electrical current through a 15-gauge needle. This study evaluated RFA for patients with hepatic malignancies considered unresectable because of their distribution, their number, and/or the presence of liver dysfunction. PATIENTS AND METHODS: Between November 1997 and February 1999, 50 patients with 132 unresectable hepatic metastases underwent RFA of tumors from 0.5 to 9 cm in diameter. There were 41 colorectal metastases in 22 patients, 13 hepatomas in seven patients, 37 neuroendocrine metastases in six patients, and 41 noncolorectal metastases in 15 patients. Real-time ultrasonography was used to guide RFA, and lesions were ablated by applying temperatures of approximately 100 degrees C for 8 minutes. Overlapping ablations were used for larger lesions. In patients with multiple lesions, RFA was performed simultaneously with cryosurgery, resection, and/or hepatic arterial infusion. RESULTS: RFA was undertaken percutaneously on an outpatient basis in 13 patients (25 lesions). The remaining patients underwent RFA via laparoscopy (21 patients; 58 lesions) or celiotomy (16 patients; 49 lesions); mean hospital stay was 1 and 5 days, respectively. RFA was the sole therapy in 28 patients and was additional therapy in 22 patients. At a median follow-up of 6 months, 27 patients were free of disease, 17 were alive with disease, and six had died of their disease (three colon, three melanoma). Three patients whose disease recurred at a prior RFA site underwent successful percutaneous RFA. Overall, there was a significant postoperative reduction in levels of carcinoembryonic antigen, alpha-fetoprotein, serotonin, and 5-hydroxyindoleacetic acid. Intraoperative ultrasonography identified unrecognized hepatic lesions in 12 of 37 patients (32%); these lesions were successfully ablated. When performed with cryosurgery, RFA reduced the morbidity of multiple freezes. DISCUSSION: RFA is a safe and effective alternative for the ablation of unresectable hepatic malignancies and when used adjunctively can reduce the morbidity of cryosurgery. Percutaneous and laparoscopic RFA can be performed effectively with less than 24 hours of hospitalization. Intraoperative ultrasonography is essential for accurate staging.     

Cytoreductive surgery with placement of intra-arterial infusion pump for unresectable liver tumors

The initial results are discussed of treatment protocol for unresectable liver tumors using combinations of cytoreductive surgery (resection and/or radiofrequency ablation (RFA)) and hepatic artery infusion pump (HAIP) placement to be followed by chemotherapy. Out of 14 patients with unresectable liver tumors (2003-2006), 12 were operated on for colorectal metastases, 1 - hepatocellular carcinoma, and 1 metastatic carcinoid. Seven patients received RFA, 4 - resection+RFA+ HAIP, and 3 - resection+ HAIP. All patients were given HAIP postoperatively. No grave complications were reported. Mean follow-up was 14 months (6-38) with an average of 6 chemotherapy cycles (2-12) per patient. At present, 8 patients have survived 6-38 months and continue to receive regional chemotherapy; overall 1- or 2- year survival is 85 and 57%, respectively. Six patients died from tumor progression within 4-21 months.     

Radio-frequency ablation (RFA) assisted endoscopic hepatectomy for hepatocellular carcinoma

We introduced a new therapeutic approach for hepatocellular carcinoma (HCC); Radio-frequency ablation (RFA) assisted endoscopic hepatectomy (RFA-assisted EH). Seven patients with HCC, smaller than 3 cm and located on the surface of the liver, were entered into this study. RFA on the hepatic cutting line was achieved with a 2 cm Cool-tip needle at a 1-cm interval. RFA power was gradually increased to 100 W in a minute and ablation was stopped once an impedance-out state was attained of RFA power. Hepatic resection was achieved with various items in a coagulative hepatic parenchyma. If necessary, additional RFA could be performed during the hepatectomy. Patients' characteristics were described as follows; average age: 64 years, 5 males and 2 females, liver damage A: 5, B: 2, average tumor size: 27 mm, and average tumor number: 1.3 Two thoracoscopic and 5 laparoscopic approaches were selected. One application of RFA could make an elliptical coagulative area (2 cm x 1 cm). RFA was achieved eleven times on the hepatic cutting line and three times during the hepatectomy. The average operating time and blood loss was 256 minutes and 96 g, respectively. No blood product was needed. The average postoperative hospital stay was 11 days and no operative complication was encountered. All of the patients were well and without recurrence during the observation period (average: 6 months). We positively recommend RFA-assisted EH for HCC due to its perfect radicality and safety.     

A case of laparoscopic radiofrequency ablation for liver metastatic tumor from colorectal carcinoma

Hepatic resection is a first choice for resectable liver metastatic tumor from colorectal carcinoma. In the case of unresectable tumor or a refusal to operation, laparoscopic radiofrequency ablation (RFA) becomes an option to treat. We report a case of laparoscopic RFA for liver metastatic tumor from colorectal carcinoma. A 74-year-old woman had a laparoscopic transverse colectomy for transverse colon cancer with multiple liver metastases in February 2009. She received UFT/LV and liver metastases were reduced. After the second course, the patient desired to stop chemotherapy. But the liver metastases had grown again. We recommended a hepatic resection. Since she didn't want to have the operation, we performed RFA. After the RFA, a liver metastasis was detected twice. After tumors were located near other organs, we performed a laparoscopic RFA. At 9 months after undergoing last RFA, she had no recurrence in the liver. We thought laparoscopic RFA was safe and effective for the lesion, which was difficult to treat with percutaneous approach RFA.     

Radiofrequency ablation of unresectable hepatic malignancies: lessons learned

Radiofrequency ablation (RFA) is increasingly used for the local destruction of unresectable hepatic malignancies. Relative contraindications include tumors in proximity to vital structures that may be injured by RFA and lesions whose size exceeds the ablation capabilities of the probe system employed. Given current technology, we believe that RFA should be cautiously utilized for lesions greater than 5 cm in diameter. Open (celiotomy) and laparoscopic approaches to RFA allow intraoperative ultrasonography, which may demonstrate occult hepatic disease. In addition, RFA performed via celiotomy can be accompanied by resection or cryosurgical ablation, and isolation of the liver from adjacent organs. Percutaneous RFA should be reserved for patients who cannot undergo general anesthesia, those with recurrent or progressive lesions, and those with smaller lesions sufficiently isolated from adjacent organs. Complications may be minimized when these approaches are selectively applied.     

Radiofrequency ablation]

RF interstitial thermal ablation (RFA) has yielded satisfactory results in the treatment of both primary and secondary hepatic tumors with no serious complications. We describe our experience with 163 patients who had this treatment. We used the RITA Needle electrode (model 30; four hooks, model 70; seven hooks) in 101 cases, the LeVeen Needle electrode in 32 cases and the Cool-tips type electrode in 30 cases. Post treatment tumor necrosis was evaluated by dynamic CT or SPIO MRI in all cases. The mean number of RFA sessions to complete tumor nodule treatment was 1.2 (1 session; 85%, 2 sessions; 12%, more than 3 sessions 3%). The mean complete necrosis area of single ablation with RITA Needle electrode was 31.3 +/- 6.1 mm x 29.6 +/- 5.5 mm. Seventy-two patients were followed up for 6-24 months (means; 15.2 months). Of these patients, 4 (5.6%) showed local recurrence. No fatal or major complications related to the treatment or to the diagnostic procedure were observed. In one of 163 patients, a moderate-to-large pleural effusion was documented after RFA, and resolved by drainage. In conclusion, RF interstitial thermal ablation of hepatic tumor is a safe and effective technique for hepatic tumors.     

Nonsurgical methods for liver metastases including cryotherapy,radiofrequency ablation,and infusional treatment: what's new in 2001?

Surgical resection is now well accepted as the standard treatment in 10 to 20% of patients with liver metastases. Tumor ablative techniques have been developed in recent years. The basic idea is to use them in patients with a limited number of intrahepatic deposits that are not totally resectable. Several papers published in 2001 have addressed cryotherapy. Cryotherapy can be considered an effective method for local destruction of liver metastases up to 3 to 4 cm in diameter but is also associated with a significant rate of complications. In many centers, cryoablation has now been replaced by radiofrequency ablation, the most widely used method for ablation of unresectable liver metastases. It can be performed during laparotomy, at laparoscopy, or percutaneously. Tumors less than 3 cm in their greatest diameter can be destroyed with one placement of the needle electrode. Metastases larger than 3 cm require several placements. Both cryotherapy and radiofrequency ablation are effective methods to induce necrosis of liver metastases. It is likely that in the near future, most patients with liver metastases will receive a multimodality treatment: a local treatment such as surgical resection or tumor ablation, and a general treatment such as hepatic infusional or systemic chemotherapy. Trials published in 2001 have shown that oral prodrugs of fluorouracil were probably equivalent to fluorouracil bolus administration. Regimens containing oxaliplatin or irinotecan have also been evaluated for efficacy and tolerance and by the intravenous route alone or in combination with hepatic artery infusion. Effective systemic chemotherapy regimens have resulted in increased survival rates and improved quality of life and in some cases have allowed resection of initially unresectable liver metastases.     

Radiofrequency ablation: identification of the ideal patient

Radiofrequency (RF) ablation (RFA) is a relatively new modality that is being used for lung tumors with increasing frequency. Radiofrequency energy consists of an alternating current that moves from an active electrode that is placed within the tumor to dispersive electrodes that are placed on the patient. As the RF energy is applied, frictional heating of tissues results, with cell death occurring at temperatures > 60 degrees C. This article discusses preclinical and early clinical experience with RFA for lung tumors. Radiofrequency ablation has been used for patients with primary lung cancer and limited pulmonary metastases. Current data suggest that RFA is most suitable for tumors < or = 4 cm in size and is better for peripheral rather than centrally based nodules. Additionally, studies of RFA followed by resection have demonstrated a learning-curve effect with improved tumor kill in the later cases performed in these series. Surgical resection should continue to be the primary modality offered to patients with early-stage non-small-cell lung cancer and limited metastatic disease to the lungs (when the primary tumor is controlled). Radiofrequency ablation is a good option for those patients who are believed to be at increased risk for resection or who refuse resection, when operation would otherwise be appropriate therapy. Additionally, RFA may be used for local control of peripheral tumors in patients with more advanced cancers in combination with other therapies.     

射频消融联合动脉栓塞治疗肝脏巨大血管瘤的疗效分析（英文）

目的：对射频消融（RFA）联合动脉栓塞（TAE）治疗巨大肝血管瘤的疗效进行回顾性分析。方法：对2004年至2008年应用RFA联合TAE模式治疗的27例巨大肝血管瘤患者进行回顾性分析,共纳入31个瘤体,直径6cm-18.5cm。所有患者首先给予TAE治疗（一次或多次）,在包块明显缩小后,进而给予RFA治疗。随访时间为12-64月（最后一次RFA治疗后,中位时间38个月）。所有患者均根据增强CT结果评价疗效。结果：本组患者无严重并发症以及死亡发生。RFA治疗3个月后,21例患者的症状减轻或消失（77.8%）。并且第一次增强CT示瘤体明显缩小,其中完全坏死率为71.0%（22/31）。对于9个提示血流存在的病灶,再次行RFA治疗。至随访结束,10/31（32.3%）已回缩瘤体显示增强信号,其中5个瘤体直径增大。结论：TAE＋RFA是治疗巨大肝血管瘤的一种安全有效的模式。     

Radiofrequency ablation of adrenal tumors and adrenocortical carcinoma metastases

BACKGROUND: The current study was performed to analyze the feasibility, safety, imaging appearance, and short-term efficacy of image-guided percutaneous radiofrequency ablation (RFA) of primary and metastatic adrenal neoplasms including adrenocortical carcinoma. METHODS: The procedure was performed using 36 treatment spheres on 15 adrenocortical carcinoma primary or metastatic tumors in eight patients over 27 months. Tumors ranged from 15 to 90 mm in greatest dimension with a mean of 43 mm. All patients had unresectable tumors or were poor candidates for surgery. Mean follow-up was 10.3 months. RESULTS: All patients were discharged or were free of procedure-related medical care 6-48 hours after the procedures without major complications. All treatments resulted in presumptive coagulation necrosis by imaging criteria, which manifested as loss of previous contrast enhancement in ablated tissue. Eight of 15 (53%) posttreatment thermal lesions lost enhancement and stopped growing on latest follow-up computed tomographic scan. Three of 15 (20%) demonstrated interval growth and four did not change in size. Of these four lesions, two showed contrast enhancement. For smaller tumors with a mean greatest dimension less than or equal to 5 cm, 8 of 12 (67%) tumors were completely ablated, as defined by decreasing size and complete loss of contrast enhancement. Three of 15 (20 %) tumors and related thermal lesions were found to have disappeared nearly completely on imaging. CONCLUSIONS: Percutaneous, image-guided RFA is a safe and well tolerated procedure for the treatment of unresectable primary or metastatic adrenocortical carcinoma. The procedure is effective for the short-term local control of small adrenal tumors, and is most effective for tumors less than 5 cm. The survival rate for patients with adrenocortical carcinoma improves when radical excision is performed in selected patients. Aggressive local disease control may potentially influence survival as well. However, further study is required to evaluate survival impact, document long-term efficacy, and to determine if RFA can obviate repeated surgical intervention in specific clinical scenarios.     

Radiofrequency ablation and percutaneous ethanol injection in patients with small hepatocellular carcinoma: a comparative study

BACKGROUND: Radiofrequency ablation (RFA) is a novel thermal ablation technique to achieve coagulative necrosis of hepatocellular carcinoma. A study was conducted to compare the antitumor effect and adverse effect of RFA with those of percutaneous ethanol injection (PEI) in patients with solitary small hepatocellular carcinoma. METHODS: The study population consisted of 119 consecutive patients with solitary hepatocellular carcinoma smaller than 3 cm in diameter. Among these, 23 patients were treated with RFA and the remaining 96 patients were treated with PEI. The antitumor effects of both treatments were assessed by contrast-enhanced computed tomography 1 month after treatment. RESULTS: Complete tumor necrosis was achieved in 23 patients (100%) of the RFA group and 90 patients (94%) of the PEI group (p = 0.48) and local recurrence rates at 1 year were 15% in the RFA group and 14% in the PEI group (p = 0.80). RFA required an average of 1.5 sessions to achieve complete necrosis, whereas PEI required an average of 4.0 sessions. As a consequence, the hospital stay in the RFA group (median 10 days) was significantly shorter than that in the PEI group (median 17 days). There were no serious adverse effects or complications except for one case of cholangitis in the PEI group, although deterioration of serum transaminase after RFA was significantly more severe than that after PEI. CONCLUSION: RFA achieved complete tumor necrosis for small hepatocellular carcinoma with fewer treatment sessions compared with PEI. There were no serious complications.     

射频消融治疗腹膜后和盆腔恶性肿瘤

[目的]探讨射频消融治疗腹膜后和盆腔恶性肿瘤的疗效和安全性.[方法]腹膜后和盆腔恶性肿瘤患者9例,均为单发病灶.其中原发性肾上腺梭形细胞瘤术后复发1例,软骨肉瘤术后腹膜后转移2例,肺癌、恶性胸腺瘤术后1例,胰腺癌腹膜后转移1例,直肠癌和子宫颈癌术后盆腔转移各1例.CT引导下进行射频消融术.[结果]腹膜后和盆腔肿块射频消融术共19次,平均2.1次.9例患者临床症状不同程度减轻或消失,临床缓解率100%.增强CT复查完全热凝固坏死4例,不完全坏死3例,部分坏死2例.患者术中较好地耐受治疗,术后未发生严重并发症.[结论]射频消融治疗腹膜后和盆腔恶性肿瘤安全,对直径小于6cm的肿瘤疗效确切.