TITLE:
Single-Step Combined Laparoscopic Management of Hepatocellular Carcinoma with Simultaneous Radio Frequency Ablation and Trans-Arterial Embolization in Unresactable Lesions
AUTHORS:
Lukman Cheraghvandi, Michael Silva, Charlie Cheng, Mauro Montalbano, Ali Shirafkan, Cristiana Rastellini, Luca Cicalese
KEYWORDS:
Single Step, Single Session, Hepatocellular Carcinoma, Laparoscopic, Radiofrequency Ablation, Trans-Arterial Embolization
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.7 No.13,
December
2,
2016
ABSTRACT: Hepatocellular
carcinoma (HCC) is a cancer with increasing incidence in the USA and high
mortality rate. HCC is often difficult to treat due to underlying comorbidities
such as cirrhosis. However, the application of loco-regional thermal ablation using
radio frequency (RF) and trans-arterial embolization with chemotherapy (TACE)
or without (TAE) has shown promising results in the treatment of patients not
amenable to surgical resection or liver transplantation. Conventionally, RF and
TAE are performed in two separated sessions or two steps and often RF ablation
is performed percutaneously. However, no consensus has been reached regarding
the ideal interval between the two treatments. In this article, we discuss the
feasibility and benefits of a single-step TAE in combination with laparoscopic
RF ablation in one operative session. We also present a case where this
procedure has been successfully performed demonstrating its feasibility. We
suggest that the use of laparoscopic RF ablation in the same surgical session
as TAE is feasible and potentially offers several advantages over the two-step
process that is usually performed with embolization followed by percutaneous RF
with a long time interval. In this article we discuss such advantages.