All of the following are modalities of therapy for hepatocellular carcinoma except
Radiofrequency ablation
Transaerial catheter embolization
Percutaneous acetic acid
Nd Yag laser ablation
.Treatment modalities for hepatocellular carcinoma includes Definitive Treatment * When limited to one lobe, hemihepatectomy is done. (Removal of 80% liver is compatible with life). Laparoscopic resection is becoming popular. Indications for transplantation in HCC are - * Patient who is not a candidate for resection * Tumour less or equal to 5 cm * Tumour less than 3 in number * Tumour without poal/hepatic vein invasion * Tumour without extra hepatic spread Palliative Treatment * Radiofrequency ablation (RFA): It is thermal ablation of the tumour by passing 18 G needle into the middle of the tumour and passing electric current of 500 kHz. This creates frictional heat causing sphere of necrosis. * Per-cutaneous ethanol or acetic acid injection: (Rule of 3 is used here- indicated in HCC not >3cm and not > 3 nodules). * Intra-aerial chemotherapy using Adriamycin / cisplatin/mitomycin through gastroduodenal aery. Adjuvant Therapy * Systemic chemotherapy using intravenous adriamycin (doxorubicin), cisplatin, carboplatin, mitomycin C, 5 fluorouracil. * Octreotide is used along with other chemotherapeutic agents. It decreases the size of the tumour. ref:SRB&;s manual of surgery,ed 3,pg no 542
G.I.T