Study of the enhancing effect of sodium chloride injection on radiofrequency ablation of hepatocellular carcinoma

Abstract 

Background and study aims

One of the potential strategies to increase the efficacy of RFA is to modulate the biologic environment of the treated tissues. Several investigators have studied increasing RFA heating by combining intra-tumoral injections of different concentrations of sodium chloride with RFA. The aim of this study is to assess the enhancing effect of normal saline (NS) on radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) using a cool-tip needle.

Patients and methods

This study included 40 patients with HCC (proved by histopathology or combined spiral CT and elevated alpha-fetoprotein). They were randomly divided into two groups (20 patients in each group). The first group was treated with RFA preceded by intra-tumoral normal saline injection (RFA+S); the second group was treated with RFA only (RFA).

Results

The procedure was successful in all patients (100%) of the RFA+S group and in 11 (55%) of the RFA group (as proved by spiral CT or pathology). This difference between the two procedures was statistically highly significant (P=<0.01). No major complications occurred in either group.

Conclusions

Combined RFA and normal saline is more effective than RFA alone. Considering the reduced cost and wide availability of isotonic saline together with the easy performance of the intra-tumoral injection, the dramatic improvement in therapeutic effect of RFA to 100% could be a breakthrough in future strategies to modernize the RFA technique.

Keywords: Hepatocellular carcinoma, Radiofrequency ablation, Sodium chloride injection