Combined radiofrequency ablation and ethanol injection with a multipronged needle for the treatment of medium and large hepatocellular carcinoma

To evaluate the efficacy and safety of combined radiofrequency ablation (RFA) and ethanol injection with a multipronged needle in the treatment of medium (3.1–5.0 cm) and large (5.1–7.0 cm) hepatocellular carcinoma (HCC). A total of 65 patients with 67 HCC nodules were enrolled in this prospective study. All of them received the treatment of combined RFA and multipronged ethanol injection percutaneously. The average volume of injected ethanol was 14.4 ± 4.1 ml (range, 9–30 ml). The average number of RFA electrode insertions was 1.7 ± 0.8 (range, 1–4). The rate of initial local complete response (CR) was 94.0 % (63/67). After additional treatment, technical success was achieved in all HCC nodules. There were no treatment-related deaths, and major complications were observed in 3 (4.6 %) patients. After a mean follow-up of 20.0 ± 7.6 months, local tumour progression was observed in 10 (10/67, 14.9 %) tumours, whereas distant recurrence developed in 32 (32/65, 49.2 %) patients. The 1-year and 2-year survival rates were 93.1 % and 88.1 %, respectively. The combination of RFA and multipronged ethanol injection in the treatment of medium and large HCC is safe and effective with a high rate of local tumour control. • Combined radiofrequency ablation and multipronged ethanol injection is a new therapeutic strategy • Treatment is safe and effective for medium and large hepatocellular carcinoma (HCC) • A multipronged needle allows for a homogeneous ethanol distribution