Original Article Percutaneous Radiofrequency Ablation for Hepatocellular Carcinoma

Radiofrequency ablation (RFA) has been employed for treatment of malignant liver tumor since 1993. Growing evidences have shown that RFA is superior to percutaneous ethanol injec-tion in terms of fewer treatment sessions, more predictable ablation extent, lower local tumor progression, higher overall survival and cancer-free survival for small hepatocellular carcinoma (HCC). RFA was comparable to microwave coagulation therapy in local tumor progression but a fewer ablation sessions were required by RFA. For larger (> 3cm) HCC, combine ethanol in-jection or chemoembolization with RFA is superior to RFA alone. Comparing with resection, RFA is equivalent to resection in terms of 3 or 4-year overall survival in a retrospective study by Hong SN et al and a randomized controlled trial by Chen MS et al. In HCC with high-risk location, the operators can improve the visibility of the tumor, improve ablation effects and re-duce the complications by creation of artificial ascites or pleural effusion immediately before RFA. Recent advances in RFA are aimed to enlarge the ablation zone in a shorter time by util-izing the higher power RF generators or bipolar RF electrodes. In summary, RFA is the choice of local ablations for small HCC. For larger HCC, combine RFA and ethanol injection or chemoembolization is superior to RFA alone. The 3 or 4-year overall survival was nearly com