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©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
Hydrochloric acid enhanced radiofrequency ablation for treatment of large hepatocellular carcinoma in the caudate lobe: Report of three cases
Han-Xia Deng, Jin-Hua Huang, Wan Yee Lau, Fei Ai, Min-Shan Chen, Zhi-Mei Huang, Tian-Qi Zhang, Meng-Xuan Zuo
Han-Xia Deng, Jin-Hua Huang, Fei Ai, Zhi-Mei Huang, Tian-Qi Zhang, Meng-Xuan Zuo, Department of Minimally Invasive Interventional Therapy, Cancer Centre of Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
Han-Xia Deng, Jin-Hua Huang, Fei Ai, Min-Shan Chen, Zhi-Mei Huang, Tian-Qi Zhang, Meng-Xuan Zuo, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, Guangdong Province, China
Wan Yee Lau, Min-Shan Chen, Department of Hepatobiliary Surgery, Cancer Centre of Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
Wan Yee Lau, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
Author contributions: Huang JH made the study concept and designed the study; Huang JH, Deng HX, and Ai F drafted the manuscript; Lau WY, Chen MS, and Fan YF made critical revision of the manuscript for important intellectual content; Huang ZM and Zhang TQ provided the technical support.
Supported by the National Natural Science Foundation of China, No. 81771955.
Informed consent statement: Written informed consent was obtained from the patients.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jin-Hua Huang, MD, Professor, Department of Minimally Invasive Interventional Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road East, Guangzhou 510000, Guangdong Province, China.
huangjh@sysucc.org.cn
Telephone: +86-020-87343447
Received: November 7, 2018
Peer-review started: November 12, 2018
First decision: November 27, 2018
Revised: December 23, 2018
Accepted: January 3, 2019
Article in press: January 3, 2019
Published online: February 26, 2019
Processing time: 112 Days and 0.1 Hours
BACKGROUND
To report on the use of percutaneous hydrochloric acid (HCl) enhanced radiofrequency ablation (HRFA) for the treatment of large (maximum diameter ≥ 5 cm) hepatocellular carcinoma (HCC) in the caudate lobe.
CASE SUMMARY
Between August 2013 and June 2016, three patients with a large HCC (maximum diameter: 5.0, 5.7, and 8.1 cm) in the caudate lobe were treated by transarterial chemoembolization followed by computer tomography (CT) guided RFA using a monopolar perfusion RF electrode, which was enhanced by local infusion of 10% HCl at 0.2 mL/min (total volume, 3 to 12 mL). The output power of HRFA reached 100 W, and the average ablation time was 39 min (range, 15 to 60 min). Two patients each underwent one session of HRFA and one patient two sessions. After treatment, CT/magnetic resonance imaging showed that all the three lesions were completely ablated. There was no major complication. Two patients had asymptomatic bile duct dilatation. One patient died of tongue cancer 24 mo after ablation. The remaining two patients were alive and no area of enhancement is detected in the caudate lobe at 28 and 60 mo after ablation, respectively.
CONCLUSION
Percutaneous CT-guided HRFA is safe and efficacious in treating large HCC in the caudate lobe.
Core tip: Caudate lobe hepatocellular carcinoma (HCC) was considered highly technically difficult by surgeons and the outcome of interventional therapies, including transarterial chemoembolization and conventional radiofrequency ablation (RFA), according to previous studies was unsatisfied. Hydrochloric acid enhanced RFA, an innovative technique, can create an ablation zone larger than 5 cm by a single perfusate electrode without major complications, which is promising to treat large caudate lobe HCC patient.
