Radiofrequency Ablation in Treating Patients With Liver Cancer and Cirrhosis

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Diagnosis of hepatocellular carcinoma (HCC), meeting 1 of the following criteria:
• •* Histologically confirmed HCC
• •* Discrete non-biopsied hepatic tumors, meeting 1 of the following criteria:
• •* Hypervascular tumor \> 2 cm by 2 imaging studies
• •* Hypervascular tumor \> 2 cm by a single imaging study AND alpha-fetoprotein ≥ 400 ng/mL
• •* Discrete non-biopsied hypervascular hepatic tumors by 2 consecutive imaging studies (e.g., CT scan or MRI) with documented tumor growth \> 1 cm in diameter
• •Histologically confirmed cirrhosis OR typical findings of cirrhosis (i.e., nodular liver, splenomegaly, varices, or ascites) by CT scan and/or MRI scan
• •Single hepatic tumor \> 3.0 cm but ≤ 5.0 cm in diameter OR 3 or fewer hepatic tumors ≤ 3.0 cm in diameter
• •* No excessive intrahepatic tumor burden (i.e., \> 3 hepatic tumors OR a single hepatic tumor \> 5 cm OR more than 3 vague hypervascular nodules \> 1 cm)
• •Tumor(s) ≥ 1 cm from the main, right, and left portal veins and hollow viscera
• •* No hepatic or portal vein tumor invasion
• •Tumor(s) \> 1 cm treatable by percutaneous radiofrequency ablation
• •No extrahepatic tumor
• •Not a surgical candidate due to any of the following reasons:
• •* Tumor in an unresectable location
• •* Comorbid disease
• •* Insufficient hepatic reserve
• •PATIENT CHARACTERISTICS:
• •Age
• •18 and over
• •Performance status
• •Zubrod 0-2
• •Life expectancy
• •Not specified
• •Hematopoietic
• •No uncorrectable coagulopathy
• •Hepatic
• •Not specified
• •Renal
• •Creatinine ≤ 2.0 mg/dL
• •Other
• •Not pregnant
• •Negative pregnancy test
• •Fertile patients must use effective contraception
• •No active symptomatic bacterial or fungal infection that is newly diagnosed and/or requires treatment
• •No absolute contraindication to IV iodinated contrast (i.e., history of significant contrast reaction not mitigated by appropriate premedication)
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy
• •Not specified
• •Chemotherapy
• •No prior or concurrent chemotherapy for HCC
• •No prior or concurrent chemoembolization for HCC
• •Endocrine therapy
• •Not specified
• •Radiotherapy
• •No prior or concurrent radiotherapy for HCC
• •Surgery
• •No prior choledochoenteric anastomosis
• •No prior sphincterotomy of duodenal papilla
• •Other
• •No prior or concurrent cryoablation for HCC
• •No other prior or concurrent therapy for HCC
• •At least 7 days since prior aspirin
• •At least 24 hours since prior ibuprofen
• •At least 12 hours since prior low molecular weight heparin preparations