Indications and contraindications for RFA for hepatocellular carcinoma

  Indications for RFA treatment of hepatocellular carcinoma: 1. Single tumor with diameter ≤ 5 cm or multiple tumors within 3 tumors with maximum diameter ≤ 3 cm, no intrahepatic primary vascular or bile duct branch invasion or distant metastasis, liver function Child-Pugh grade A or B. RFA technique can be applied alone, or RFA treatment can be performed electively after TACE/TAE (transcatheter arterial chemoembolization/transcatheter arterial embolization).  2.Single tumor with diameter >5cm or multiple tumors with maximum diameter >3cm, with liver function Child-Pugh grade A or B. Most of them are combined with other minimally invasive interventional techniques, such as TACE/TAE first, and then RFA treatment at an elective stage.  3.Tumor remnant/recurrence/new tumor after surgical resection, RFA, TACE/TAE, etc. of hepatocellular carcinoma; intermediate and advanced hepatocellular carcinoma that cannot be resected; liver function Child-Pugh grade A and B.  4. Patients waiting for tumor growth control before liver transplantation as well as recurrence and metastasis after transplantation.  Absolute contraindications: (1) Impaired consciousness.  (2) Diffuse hepatocellular carcinoma of the whole liver.  (3) Heart, lung, liver, kidney and other major organ failure.  (4) Biliary system infection and sepsis.  (5) Uncorrectable coagulation dysfunction.  Relative contraindications: (1) Carcinoma thrombosis of the main trunk of the hepatic portal vein, carcinoma thrombosis of the inferior vena cava of the liver segment.  (2) Moderate to large amount of ascites.  (3) Child-Pugh grade C liver function.  (4) PTA<50%.  (5) PLT<50×109/L. (6) TBIL≥51μmol/L.