Abstract：Objective To evaluate the efficacy and the application value of TACE combined with CT guided percutaneous radiofrequency ablation in the treatment of large hepatocellular carcinoma. Methods A retrospective analysis was made on clinical data of 52 patients proved by pathology and imaging diagnosis of hepatocellular carcinoma. All the patients received one TACE treatment, and were reexamined by contrast-enhanced CT two weeks thereafter. Then radiofrequency ablation was performed on the region lacking lipiodol deposition under CT guidance. Postoperatively, all the patients were reexamined by alpha fetoprotein, contrast-enhanced MRI or CT to evaluate the volume reduction and necrosis of tumors and were followed up for 12 months. Results The operations on all 52 patients (56 lesions) were successful without serious complications. The volumes of tumors decreased to varying degrees compared with the preoperative ones. The maximum of the diameters of the focuses was (12.7±2.7) cm before TACE, and the maximum of the diameters of the focuses was (6.1±1.9) cm after the RF ablation operations (t=14.416, P＜0.05). The AFP values decreased significantly, with the AFP value before TACE being (4156±689) ng/ml and the AFP value after the RF ablation operations being (256±178) ng/ml (t=39.485, P＜0.05). Complete ablation (CR) was found in 26 cases, ablation in the majority (PR) was found in 21 cases, 4 cases were found to be stable (SD), progress (PD) was found in 1 case, and the total effective rate was 90.4%. The 12 months survival rate was 92.3%. Conclusions TACE combined with CT guided percutaneous radiofrequency ablation is safe, effective and minimally invasive in the treatment of large hepatocellular carcinoma.
2015, Vol. 26 
