| Primary and secondary hepatic cancer is one of the most commonly in malignant tumors of human race. At present surgery is considered the only option for either primary or secondary hepatic carcinoma. However, the majority of hepatic cancers are not suitable for curative resection at the time of diagnosis. In addition, difficulties related to surgical resection are those of the size, site and numbers of tumors, extrahepatic involvement and poor liver function. Therefore, there is a need for the development of a simple and effective technique for treatment of unresectable tumors within the liver. Percutaneous ultrasound-guided radiofrequency thermal ablation(RFTA) is a new effective way recently used to treat liver tumors. It works by converting radiofrequency waves into heat. The alternating current passing down from an uninsulated electrode tip into the surrounding tissues generates changes in the direction of ions and creates ionic agitation and frictional heating, the tissue heating then drives extracellular and intracellular water out of the tissue, which results in the final destruction of the tissue as a result of coagulative necrosis. The trait for radiofrequency ablation isminimally-invasive, safe, significant and no serious complications. We report here our experience in the use of this technique for management of primary and secondary unresectable liver cancers.Objective: Color Doppler ultrasonography, contrast- enhanced CT, laboratory diagnosis and sonographically guided fine-needle biopsy to evaluate the efficacy of ultrasound guided radiofrequency thermal ablation in malignant liver tumors and explore the value in clinical practice.Materials and Methods: Thirty patients with forty-nine tumors were underwent with radiofrequency thermal ablation. Of these, 21 who had 32 primary hepatocarcinoma nodules and 9 who had 17 hepatic metastatic nodules. Forty-nine nodules with a diameter of 1.5～11.9cm(mean 5.67cm), 22 nodules＜5cm and 27 nodules＞5cm in diameter. All the patients were diagnosed using contrast-enhanced CT, color Doppler sonography and laboratory diagnosis. Pathologic diagnosis was obtained in sixteen cases by sonograghically guided biopsy. Ultrasound guided radiofrequency thermal ablation for liver cancer by using RITA 1500 type device and multi-needles radiofrequency electrode from America. For the guide, we used ultrasonic apparatus of Siemens Omnia.The RFTA treatment was performed only on inpatients, but in some cases treatment could be done in outpatients.And fast eight hours before treatment, with a hospital stay for 1~3D after treatment. It could be treated for multiple sessions.With local anesthesia we administrated lidocaine 1%, along the puncture line was done as described. Then the electrode needles that were connected directly to the radiofrequency generator. Under sonographic guidance to introduce the multi-needles radiofrequency electrode tip into the chosen area of the tumor, open the switch of RF-current generator. The temperature at the needles tip were maintained at 90℃~105℃ for 10~35min. At each insertion, the needles tip of the electrode were placed in the deepest part of the tumor. Multiple thermal lesions were created along the major axis of the electrode by withdrawing it from the thermal lesion and reactivating the radiofrequency generator. After making the prefixed thermal lesions, we turned off the radiofrequency generator, and all electrodes were removed. Multi-needles procedure made a single thermal lesion with a range that was approximately 5cm in diameter. The ablation areas were observed and the vascular flow to tumor nodules, radiographic images, tumor size, clinical findings and AFP value of before and after the treatment were compared.Results: Forty-nine nodules were successful with radiofrequency treatment. For 22 tumor nodules less than 5cm in diameter, in all but one, the one-time complete ablation was created to obtain total tumor destruction. For 27tumor nodules greater than 5cm in diameter when necessary be...
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