All of the following are modalities of therapy for hepatocellular carcinoma except
.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
Radiofrequency ablation
Transaerial catheter embolization
Percutaneous acetic acid
Nd Yag laser ablation
G.I.T