Evaluating the short term outcome of radiofrequency ablation of hepatocellular carcinoma at Binh Dan hospital

Objectives: Evaluation of technical success as complete ablation rate, tumor progression, the safety and short-term outcome of radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC). Subjects and methods: 30 patients with HCC were treated with radiofrequency ablation from Jun 1, 2014 to Jun 1, 2017 at Binhdan Hospital.
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Evaluating the short term outcome of radiofrequency ablation of hepatocellular carcinoma at Binh Dan hospitalJournal of military pharmaco-medicine no4-2018EVALUATING THE SHORT-TERM OUTCOME OFRADIOFREQUENCY ABLATION OFHEPATOCELLULAR CARCINOMA AT BINH DAN HOSPITALNguyen Van Xuyen*; Ngo Viet Thi**; Do Son Hai*Nguyen Hai Dang**; Pham Vinh Quang**SUMMARYObjectives: Evaluation of technical success as complete ablation rate, tumor progression,the safety and short-term outcome of radiofrequency ablation (RFA) in hepatocellular carcinoma(HCC). Subjects and methods: 30 patients with HCC were treated with radiofrequency ablationfrom Jun 1, 2014 to Jun 1, 2017 at Binhdan Hospital. Results: RFA was perfomedpercutaneously in 30 patients with complete ablation rate 90%, recurrence rate at 3 months,6 months and 12 months followed up was 0%, 23.33% and 30%, respectively, only one casewith minor complication (3.3%) and no treatment-related deaths was recorded. Conclusions:RFA is an effective and safe method treatment for small or unresectable HCC. However, furthercontrolled trials are needed to determine the effect of hepatic RFA on long-term survival.* Keywords: Hepatocellular carcinoma; Radiofrequency ablation; Therapy; Survival; Efficacy.INTRODUCTIONHepatocellular carcinoma is a verycommon disease in both sex. The risk forHCC is surprisingly high with chronichepatitis B, C or cirrhosis.Surveillance programs addressed tothe early detection of small nodular typeHCC in patients with chronic liver diseasesare increasing the eligibility for local orsurgical treatments.Today, curative treatment for HCCincluding liver resection, liver transplantand local therapy. However, in Vietnam,liver transplant still got many problemsdue to the lack of donor organs. Liverresection brings good results but only10 to 25% of patients are eligible tosurgery because of problems such as:multi-focal tumors, not enough functionalliver remnant etc… Therefore, the localtherapy (especially radio frequencyablation) is strongly focused nowadays togive a better outcome for the patients.At present, radiofrequency ablation(RFA) is the best indicated for small HCC(≤ 3 cm) with no more than 3 lesions orunresectable tumor or in HCC patientswho refused to undergoing liver resectionwith promising outcome. The advantagesof RFA is the high capacity of complete* 103 Military Hospital** Binh Dan HospitalCorresponding author: Do Son Hai (dosonhai.pr@gmail.com)Date received: 23/01/2018Date accepted: 26/03/2018191Journal of military pharmaco-medicine no4-2018tumor destruction, it is a less invasivetherapy which help to conserve thefunctional liver remnant with minorcomplications. Although RFA has beenutilized throughout the world, it was notfrequently applicated in Binhdan Hospitaland its efficacy is still under discussion.The aim of this research is to: Investigatethe efficacy and also the safety of FFA inHCC.SUBJECTS AND METHODS1. Subjetcs.All the patients diagnosed with HCCwere treated with RFA at BinhdanHospital from June 2014 to June 2017.Diagnosis of HCC was confirmed byspecific wash-out image on multi-slicedcomputed tomography or by core biopsy.* Inclusion criteria: The patients wereindicated for radiofrequency ablation basedon AASLD guidelines for HCC or patientswith resectable lesion but refuse toundergoing surgery.* Exclusion criteria: Patients with 4 ormore lesions, tumor diameter is more than3 cm, portal thrombosis or progressivelesion which invade portal or hepatic vein,while relative contraindication for ablativeis lesion located closely to importantorgans and serious coagulopathy (plateletcounts less than 50,000 per mm3 orPT < 50%).2. Methods.* Patients and HCC characteristics:From June 1st 2014 to June 1st 2017,30 consecutive patients fulfilling the inclusioncriteria were treated with RFA. Pretreatmentassessment was performed before each192treatment with ordinary liver function tests,prothrombin time and alpha-foetoprotein(AFP), platelet counts, chest X-ray,abdominal ultrasound and abdominalmulti-sliced computed tomography scan.The procedures were all performedpercutaneously with ultrasound guidance.The patient was followed and dischargedoff the hospital the day later if nocomplication was noticed. The surveillanceprotocol included early treatment responseassessment by contrast-enhanced CT-scanperformed 1 month after the first treatment,and a long-term response evaluation withalphafoetoprotein measurement, abdominalultrasound every 3 months with chest/abdominal CT-scan when suspect ofrecurrence or distal metastasis.The aim of this monitoring was to detectsigns of both local tumor progression andnew lesions separated from the previouslytreated nodule. Complete ablation wasdefined as no enhancements in bothperipheral or intra-nodular on arterialphase at ablative site on the 1-monthCT-scan. ...