Computed tomography-guided radiofrequency ablation of the retained iodized oil after simultaneous combination with transarterial embolization in small recurrent or residual hepatocellular carcinoma

Objective:To assess the clinical efficacy and safety of transarterial embolization(TAE)in simultaneous combination with computed tomography(CT)-guided radiofrequency ablation(RFA)for recurrent or residual hepatocellular carcinoma(HCC),and to determine the risk factors influencing local tumor progression following this procedure.Methods:One hundred eighteen patients with recurrent or residual HCC(tumor size,10–30 mm)underwent RFA.During the 19-month follow-up,59 patients received RFA only(RFA group),and the remaining 59 received RFA immediately after TAE(TAE+RFA group).All patients were followed up to observe the short-term therapeutic effects and complications.The cumulative local tumor progression rates in both groups were calculated using unpaired Student’s t tests and the Kaplan-Meier method.Results:The rate of major complications was 5.08%in the TAE+RFA group and 3.39%in the RFA group.The overall response rate was 96.61%in the TAE+RFA group and 79.66%in the RFA group(P=0.008).The disease control rate was significantly higher in the TAE+RFA group than in the RFA group(94.92%vs.79.66%,P=0.024).The median time to local tumor progression was 4.8 months in the RFA group and 9.6 months in the TAE+RFA group.The cumulative local tumor progression rate at 1 year was 10.60%in the RFA group and 23.60%in the TAE+RFA group(P=0.016).Conclusion:TAE in simultaneous combination with CT-guided RFA was effective and safe against recurrent or residual HCC.Local tumor progression can be minimized by the complete ablation of targeted iodized oil deposits after simultaneous TAE.

Effectiveness and Safety of Splenic Micro-wave Ablation Combined with Hepatic Ar-terial Chemoembolization for Hepatocellular Carcinoma Associated with Hypersplenism: A Prospective Study in 5 Patients

The aim was to prospectively evaluate the efficacy and safety of splenic microwave ablation (MWA) combined with transcatheter hepatic arterial chemoembolization (TACE) in treatment of hepatocellular carcinoma (HCC) associated with hypersplenism. Five patients suffering from primary HCC associated with hypersplenism caused by cirrhosis were received MWA combined with TACE. Follow-up examinations included calculation of peripheral blood cells (leukocytes, platelets and red blood cells) and treatment-associated complications. After treatment, leukocyte and platelet counts were significantly higher (P < 0.05) than prior-treatment. Right upper quadrant pain occurred in 3 patients, fever occurred in 4 patients, and mild nausea & vomiting occurred in 3 patients. Complications such as pleural effusion, ascites, bacterial peritonitis, and variceal bleeding did not occur after treatment. So, MWA combined with TACE is effective and safe for the patients with HCC associated with hypersplenism caused by cirrhosis.