Adrenal Metastasis From Hepatocellular Carcinoma: Radiofrequency Ablation Combined With Adrenal Arterial Chemoembolization in Six Patients

OBJECTIVE. The purpose of this study was to evaluate the clinical utility of adrenal radiofrequency ablation combined with adrenal arterial chemoembolization in the treatment of patients with adrenal metastasis of hepatocellular carcinoma. MATERIALS AND METHODS. This retrospective study was conducted at two institutions. Adrenal radiofrequency ablation and chemoembolization were performed on the same day. Safety, local tumor progression, and survival were evaluated. RESULTS. Six patients with eight adrenal metastatic lesions were treated. The mean maximum diameter of the lesions was 5.2 +/- 1.8 cm (range, 3.5-8.0 cm). During initial combination therapy, an adrenal metastatic lesion was isolated in one patient. The other five patients had four associated intrahepatic lesions and three extraadrenal distant metastatic lesions. On contrast-enhanced CT scans, tumor enhancement of all eight adrenal tumors ceased after combination therapy. No major complications were related to combination therapy. During the mean follow-up period of 37.7 +/- 27.6 months (range, 4.0-70.9 months), two of eight adrenal tumors (25%) had undergone local tumor progression. The median survival time was 24.9 months. Three patients treated for both intrahepatic and extrahepatic lesions survived longer than 4 years. CONCLUSION. The combination therapy described is a safe multidisciplinary therapeutic option that can lengthen survival among patients with adrenal metastasis from hepatocellular carcinoma.