الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
This study was conducted from May 2008 to December 2010 on 48 patients having nodular hepatocellular carcinoma ≥ 3cm up to 7 cm in diameter. Patients were randomized into two groups; (1) Acetic acid group: 28 patients that underwent PAI. (2) RFA group: 20 patients underwent RF ablation. Thirty patients (62.5%) had medium-sized hepatic focal lesion that ranges from 3.1 to 5 cm in maximum diameter while 18 patients (37.5%) had large focal lesion ranging from 5.1 to 7 cm in diameter. After three months, 79.2% was the success rate (75% in acetic acid group and 85% in RFA group) and failed in 10 patients (6 were re-ablated by the same technique and 4 patients underwent no further therapy due to development of PV thrombosis). After one year 75% and 77% were the success rates in acetic acid group in the medium-sized and large tumours, while in RFA group success rates were 91.7% and 42.9% in medium and large tumours respectively. The AFP level decreased significantly after three months. In our study, the success rate was (85%) in both groups. Survival rate after one year follow up was 81.25%, and child classification was an important tool in predicting survival after ablation. Fever, ascites, haematemesis and melena were the most common complications encountered in our study. Percutaneous acetic acid injection and RFA techniques are considered to be safe and effective for management of medium and large HCC. Better results are obtained in the medium-sized tumours in comparison with large tumors. AFP is an important tool in the follow up of HCC cases especially in cases with higher values before the procedure. Regular follow up of HCC cases is mandatory for early detection of recurrence or denovo lesions. Child classification is important in evaluating survival after tumour ablation. It is suspected that the results of combining more than 2 techniques (PAI and RFA) would give more promising results than each combination alone. More studies are needed for better management of large focal HCC. Conclusion: The results of this study show that PAI and RFA are safe and equally effective treatment for HCCs 3.1 to 7.0 cm in diameter, even for patients with cirrhosis and suboptimal hepatic function. However, studies with long-term follow-up data are awaited to further clarify their role in the treatment of this group of patients, and prospective randomized trials are needed to compare its effectiveness with that of other currently available treatments for HCC. Our results suggest that the overall efficacy and survival were not significantly different between patients receiving either treatment.