Multipolar percutaneous us-guided radiofrequency ablation of hepatocellular carcinoma(HCC)

Objectives: Multipolar radiofrequency ablation (RF) allows to extend the volume of coagulation without loss of energy from the lesion; up to three bipolar RF probes can be placed simultaneously within the tumor. The aim of this study was to prospectively evaluate the effectiveness of the multipolar RF device, and whether the extended volume of necrosis achieved might worsen the functional hepatic reserve in cirrhotic patients with (HCC).

Methods: Twenty one nodules of HCC in 21 patients (16 males; 48–78yrs) were treated using a multipolar RF ablation system under ultrasonographic guidance. Fourteen patients had Child-Pugh class A disease, and 7 had class B disease. HCC's size ranged from 3.6–6.6cm. HCCs larger than 4cm were treated positioning two or three probes within the tumor. Postinterventional treatment response was assessed with contrast-enhanced sonography and CT. Ultrasound examination was scheduled the day after the procedure. Serum laboratory tests were performed assessing ALT, prothrombin, bilirubin, and albumin levels.

Results: Complete tumor destruction was achieved in 18 of the 21 patients. In three cases, repeat ablation of peripheral tumor residue was performed in a second session and resulted in complete ablation. None major complication was observed the day after procedure at ultrasound examination, none patient had ascites or portal vein thrombosis. Laboratory tests performed prior and after procedure did not show differences.

Conclusions: Our data suggest that multipolar RF is effective and safe in the treatment of HCC on cirrhosis. Nonetheless, our results need to be confirmed in larger series of patients.