Abstract
Radiofrequency ablation (RFA) is a key treatment option for hepatocellular carcinoma (HCC) and was developed in 1995. RFA is suitable for early-stage HCC (≤3 lesions ≤3 cm in diameter; Child-Pugh score A or B according to the Japanese clinical guidelines for liver cancer; usually indicated for platelets ≥50,000mm3; absence of ascites). Indications for RFA are usually decided based on computed tomography, ultrasonography (US) and magnetic resonance imaging (MRI) and contrast medium is necessary for evaluation. RFA is usually performed under ultrasonographic guidance, and CT guidance is sometimes useful to treat the lesion, which is difficult to detect on US. Artificial ascites and/or hydrothorax are useful to detect lesions located at the dome of the liver and to protect against injury to the lung, gastrointestinal tract and so on. Treatment effects are usually evaluated using CT, and Gd-EOB-DTPA-MRI is also useful for accurate evaluation of treatment margins in RFA. Phase III clinical trials of sorafenib and peretinoin are now ongoing as adjuvant therapies after RFA.
