Central European Journal of Medicine

, Volume 3, Issue 3, pp 370–373 | Cite as

A five-year disease-free survival after combined hepatectomy and radiofrequency ablation of large hepatocellular carcinoma adjacent to vena cava

  • Alexander Julianov
  • Ivan Rachkov
  • Anatoli Karashmalakov
Case Report


Destroying the hepatic tumor located close to the large vessels is a major limiting factor of radiofrequency ablation (RFA) that is difficult to overcome. A long-term disease-free survival after combined hepatectomy and radiofrequency ablation of a large hepatic tumor adjacent to vena cava has not been previously published. We report a patient with a 23-cm large hepatocellular carcinoma occupying the left lateral segments and a 6-cm contralateral intrahepatic metastasis in Couinaud segments VII–VIII adjacent to the retrohepatic IVC, treated with a combination of resection of the larger tumor and intraoperative radiofrequency ablation of the paracaval tumor under intermittent total vascular exclusion of the right hemiliver. After five years of follow up the patient is disease free. This case demonstrates the importance of vascular control for eliminating the heat sink effect of caval blood flow during RFA of liver tumors adjacent to inferior vena cava.


Hepatocellular carcinoma Liver resection Radiofrequency ablation Vascular exclusion 


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Copyright information

© © Versita Warsaw and Springer-Verlag Berlin Heidelberg 2008

Authors and Affiliations

  • Alexander Julianov
    • 1
  • Ivan Rachkov
    • 1
  • Anatoli Karashmalakov
    • 1
  1. 1.First Department of SurgeryThracian University HospitalStara ZagoraBulgaria

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