Ultrasound Guided Radiofrequency Ablation For Hepatocellular Carcinoma

Objective:Hepatocellular carcinoma has become one of the most common malignant tumors in clinic and second of the causes of tumor death in the mainland of China at present,which is the highest incidence of hepatocellular carcinoma in the world.It usually has no obvious specific symptoms in the early stage of liver cancer and has lost the best opportunity for treatment if there is obvious abdominal pain,palpable mass,gastrointestinal bleeding and so on.At present,there are many methods of treating liver cancer,including surgical treatment(including liver resection,liver transplantation),interventional therapy,systemic therapy,radiation therapy,ablation,cryotherapy,biological treatment,traditional Chinese medicine treatment.Clinically,only about 20 percent of patients with hepatocellular carcinomawas treated by radical resection,because of the location,size,number of the liver cancer and extrahepatic metastasis,especially due to liver cirrhosis,hepatitis and liver function and other influential factors.Andpercutaneous radiofrequency ablation guided by color Doppler ultrasound is a new treatment technology of cancer,which rapidly develops in recent years.Its recent curative effect is accurate and satisfactory,which has clinical value to be spread.Some scholars believe that RFA will have the potential to become the most promising and commonly used tumor ablation therapy.However,there are few studies on its prognostic factors.In this article,we discuss the data of ultrasound-guided radiofrequency ablation for hepatocellular carcinoma,clarify its effect and influential factorsand provide reference for clinical practice.Method:The clinical data of 80 patients with hepatocellular carcinoma of Nanhai District People’s Hospital undergone radiofrequency ablationfrom July 2010 to July 2012 were analyzed retrospectively,used statistical software to analyze thechanges of total bilirubin,alanine aminotransferase,aspartate aminotransferase,albumin,AFP and CEA before and after radiofrequency ablation and identified the risk factors of complications in relation to radiofrequency ablation.The χ2 test and logistic linear regression analysis in single factor analysis were used to analyze the prognosisof patients with hepatocellular carcinoma undergone radiofrequency ablation and main risk factors of local recurrence.Result:80 cases of patients with hepatocellular carcinoma undergone radiofrequency ablation is of a total of 94 times,101 lesions and the average size of lesions is(2.69±1.30cm).The complete tumor ablation rate was 85.0%(68/80)through enhanced CT a month after RFA.Liver function and tumor markers were significantlyimproved after RFA(P < 0.05).There are no significant differences in the survival time of patients with different ages,history of liver cirrhosis and hepatitis,preoperative level of AFP and frequency of radio(P>0.05).The single factor analysis showed that patients with hepatocellular carcinoma,who have grade A of ChildPughliver function,tumor≤3cm,single tumor,no adjacent to vital organs,no vascular thrombosis,sufficientrange of RFA and no invasive,have significantly longer survival time than the other patients(P<0.05).Furthermore,the multivariate analysis showed that the classification of liver function,thenumber of tumor and tumor thrombosisin vascular are independent factors for the prognostic of patients undergone radiofrequency ablation.In the analysis of factors about local recurrence rate 1 years after RFA,nine factors are related to local recurrence rate ofpatients with hepatocellular carcinoma one year after RFA,including the classification of liver function,tumor size,tumor number,liver cirrhosis,hepatitis history,ablation frequency,vascular tumor thrombosis,sufficient range of the ablation and growth pattern of tumor,which were introduced into the Cox model and done further analysis.Therefore,liver cirrhosis,hepatitis history,vascular tumor thrombosis are independent factors for local recurrence rate of patients with hepatocellular carcinoma one year after RFA.Conclusion:Taking the standardized RFA treatment of liver cancer is a local minimally invasive treatment with satisfactory curative effect,which has been widely used in clinic and has the advantages of safety,small trauma,obvious curative effect,accurate position and repeatable treatment.RFA has showed efficacy in the treatment ofhepatocellular carcinoma.Logistic regression analysis showed that Child classification of liver function,the number of tumor and vascular tumor thrombosis are independent risk factors for postoperativeprognosis of patients with hepatocellular carcinoma,and then liver cirrhosis,hepatitis history and vascular tumor thrombosis are independent risk factors for local recurrence after RFA.