Livraghi T, Goldberg S N, Lazzaroni S, Meloni F, Ierace T, Solbiati L, Gazelle G S
Department of Radiology, Ospedale Civile, Vimercate, Italy.
Radiology. 2000 Mar;214(3):761-8. doi: 10.1148/radiology.214.3.r00mr02761.
To study local therapeutic efficacy, side effects, and complications of radio-frequency (RF) ablation in the treatment of medium and large hepatocellular carcinoma (HCC) lesions in patients with cirrhosis or chronic hepatitis.
One-hundred fourteen patients who were under conscious sedation or general anesthesia had 126 HCCs greater than 3.0 cm in diameter treated with RF by using an internally cooled electrode. Eighty tumors were medium (3.1-5.0 cm), and 46 were large (5.1-9.5 cm). The mean diameter for all tumors was 5.4 cm. At imaging, 75 tumors were considered noninfiltrating, and 51 were considered infiltrating.
Complete necrosis was attained in 60 lesions (47.6%), nearly complete (90%-99%) necrosis in 40 lesions (31.7%), and partial (50%-89%) necrosis in the remaining 26 lesions (20.6%). Medium and/or noninfiltrating tumors were treated successfully significantly more often than large and/or infiltrating tumors. Two major complications (death, hemorrhage requiring laparotomy) and five minor complications (self-limited hemorrhage, persistent pain) were observed. The single death was due to a break in sterile technique rather than to the RF procedure itself.
RF ablation appears to be an effective, safe, and relatively simple procedure for the treatment of medium and large HCCs.
研究射频（RF）消融治疗肝硬化或慢性肝炎患者中、大肝细胞癌（HCC）病灶的局部治疗效果、副作用及并发症。
114例在清醒镇静或全身麻醉下的患者，使用内部冷却电极对126个直径大于3.0 cm的HCC进行了RF治疗。80个肿瘤为中等大小（3.1 - 5.0 cm），46个为大肿瘤（5.1 - 9.5 cm）。所有肿瘤的平均直径为5.4 cm。影像学检查显示，75个肿瘤为非浸润性，51个为浸润性。
60个病灶（47.6%）实现了完全坏死，40个病灶（31.7%）达到近完全（90% - 99%）坏死，其余26个病灶（20.6%）为部分（50% - 89%）坏死。中等大小和/或非浸润性肿瘤的成功治疗率明显高于大肿瘤和/或浸润性肿瘤。观察到2例主要并发症（死亡、需要剖腹手术的出血）和5例次要并发症（自限性出血、持续性疼痛）。唯一的死亡是由于无菌技术失误而非RF操作本身。
RF消融似乎是治疗中、大HCC的一种有效、安全且相对简单的方法。
