Cic edizioni internazionali
Il Giornale di Chirurgia

La termoablazione con radiofrequenza dell’epatocarcinoma.
Nostra esperienza su 2012 trattamenti

Articolo, 149 - 151
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Study: The 70% of the patients with HCC it is not susceptible of surgical resection and only the 5% of them is able to surgery. Alone 50% is monofocal really and the 93% of the patients with single HCC of smaller diameter to 2 cms will introduce new locations within 5 years making often impracticable a further liver resection. For such reasons in the years techniques are developed place regional less invasive as radiofrequency waves.
Methods: Our personal casuistry from 1996 to all enumerates 2012 liver thermal ablations, 167 mammary and 10 pulmonary. The liver TARF are so you divide: 764 for HCC, 674 for colorectal metastasis, 336 mammary, 96 ovarian, 71 from NETs, 74 gastric. 1442 TARFs are been performed with the employment of the system RITA, 165 with the system needle Radionics, 105 LTA. We have treated patient inoperable for center, dimensions, distribution of the lesions, for choice of the patient and for tall surgical risk..
Results: The complete ablation is gotten in 96,9% against the 88,2% of the colorettal metastasis and the 91,2% of the brast carcinoma.
The global survival has respectively been of 99%, 92%, 68%, 55%, 20% to 1-2-3-4-5. New lesions of HCC have appeared in 24% a first year, in 45% to the second, in 62% in the third one, in 73% in the quarter, in 76% in the in the fifth year.
Discussion: The thermal ablation with radiofrequency (TARF) uses waves to 460kHz that they determine ionic intracellular movement and heat around the electrode producing coagulative of the proteins.
The least satisfactory results are gotten for tumours of great diameter to 3 cms. Not there are no meaningful differences of the global survival if ablation has been complete or incomplete and further termoablazioni they increase the survival (1). The study of Mazzferro
demonstrated that 63% of the cases with HCC < 3 cms have gotten a complete answer and that the probability of recidivist increases of 59% to 12 months and of 70% to 18 months. The values change in presence of new locations 96,6-74,8-42,1 to 1-3-5. In literature the local recidivist is of 9%, 14,1%, 17,7% to 1-2-3 whereas the border of thermal ablatione has been < 5 mm. The distant recidivous 10,4%-52,5%-77% to 1-3-5.
Conclusions: The TARF is more frequently the treatment employee in the HCC.The advantages offered by the TARF are represented by the efficacious methodic.and the rare complicanzes.

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    Nostra esperienza su 2012 trattamenti

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