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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.

journal of cancer therapy

Single-Step Combined Laparoscopic Management of Hepatocellular Carcinoma with Simultaneous Radio Frequency Ablation and Trans-Arterial Embolization in Unresactable Lesions