Purpose
To report the initial experience of intraoperative RF ablation and following tumorectomy of residual or recurrent viable tumor in liver dome after TACE of HCC.
Material and methods
Four patients (M:F = 3:1; 49–67 years) with residual or local recurrent viable tumor in liver dome after TACE were treated. The number of previous TACE was 3-5 (mean, 4.3) and tumor size was 3.4 to 6.4 cm (mean, 4.7 cm). RF ablation was done at planned surgical resection margin including tumor, and done with monopolar (n=2) or cluster cooled electrodes (n=2). After RF ablation, tumorectomy was followed. One month later, treatment response was assessed by CT and then was assessed by two or three months follow up CT.
Results
All tumor were attached to diaphragm (metastasis =1, adhesion =3). Pathologic specimen showed clear resection margin and tumor necrosis more than 90%. No complication except one pneumothorax was occurred. Complete ablation was achieved in all tumors on initial one month follow up CT. After a median follow up of 8.3 months (range, 5 -12 months), all four patients showed tumor-free.
Conclusion
Intraoperative RF ablation and following tumorectomy is a safe and effective treatment for residual or local recurrent viable tumor in liver dome after TACE of HCC.