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ORIGINAL ARTICLE
Year : 2020  |  Volume : 33  |  Issue : 3  |  Page : 819-823

Comparative study of radiofrequency ablation combined with either percutaneous ethanol injection or percutaneous acetic acid injection in the management of hepatocellular carcinoma


1 Department of Tropical Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Correspondence Address:
Haytham M Azab
Shiekh Zayed 12588, Giza Governorate
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_408_18

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Objective The objective of this study was to compare radiofrequency ablation (RFA) plus percutaneous ethanol injection with RFA plus percutaneous acetic acid injection in hepatocellular carcinoma (HCC) treatment in patients having single focal lesions more than 5 cm and up to 7 cm in diameter. Background RFA has proved its effectiveness and safety between various local ablative therapies. Acetic acid, which has the ability to penetrate cells with the property of extracting collagen and dissolving lipids, has a stronger killing effect on hepatocytes than ethanol. Patients and methods This prospective study was carried out from April 2014 to January 2017; it included 60 patients with compensated HCC who had a single lesion more than 5 cm and up to 7 cm in diameter; they were Child A. The patients were selected according to the triphasic computed tomography scanning characteristics of HCC. They were randomly allocated into two groups: group I was ablated for one setting of RFA, followed by percutaneous ethanol injection in the same setting. Group II was ablated by one setting of RFA with two overlaps to decrease the size of the unablated areas, followed by percutaneous acetic acid injection in the same setting. Results Evaluation of the response to ablation 1 month later using triphasic computed tomography showed significant better responses in group II compared with group I (83.3 vs. 60%). The response 3 months later was not changed significantly compared with the response after 1 month. Conclusion Combined techniques give the best results for management of HCCs in comparison with individual techniques. Acetic acid-enhanced RFA is a very effective method of HCC ablation.


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