Radiofrequency ablation versus transarterial chemoembolization for unresectable solitary hepatocellular carcinomas sized 5-8 cm.

Abstract

OBJECTIVES:

This retrospective review was conducted to compare the efficacy of radiofrequency ablation (RFA) with that of transarterial chemoembolization (TACE) in treating large (5-8 cm) unresectable solitary hepatocellular carcinomas (HCCs).

METHODS:

Patients with large unresectable solitary HCCs primarily treated by RFA or TACE were reviewed. The primary endpoint was overall survival. Secondary endpoints were tumour response, time to disease progression, and treatment-related morbidity and mortality.

RESULTS:

There were 15 patients in the RFA group. Of these, 12 achieved complete ablation, one had ablation site recurrence, and five developed complications. Median disease-free survival in this group was 13.0 months (range: 2.8-38.0 months). The TACE group included 26 patients, of whom four obtained a partial response, none achieved a complete response, and five developed complications. The median time to disease progression in this group was 8.0 months (range: 1.0-68.0 months). There were no hospital deaths in this series. Median survival was 39.8 months in the RFA group and 19.8 months in the TACE group (P = 0.257). Rates of 1-, 2- and 5-year survival were 93.3%, 86.2% and 20.9%, respectively, in the RFA group and 73.1%, 40.6% and 18.3%, respectively, in the TACE group.

CONCLUSIONS:

Both RFA and TACE are feasible treatments for large unresectable solitary HCCs. Both modes show comparable rates of complications and longterm survival, but RFA achieves better initial tumour control and results in better short-term survival.

• Authors: Wing Chiu Dai, Tan To Cheung, Kenneth S H Chok, Albert C Y Chan, William W Sharr, Simon H Y Tsang, Wai Key Yuen, See Ching Chan, Sheung Tat Fan, Chung Mau Lo, Ronnie T P Poon
• Journal: HPB : the official journal of the International Hepato Pancreato Biliary Association (HPB (Oxford)) Vol. 17 Issue 3 Pg. 226-31 (Mar 2015) ISSN: 1477-2574 [Electronic] England
• PMID: 25284590 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2014 International Hepato-Pancreato-Biliary Association.

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Hepatocellular (mortality, pathology, surgery, therapy)
• Catheter Ablation (adverse effects, methods)
• Chemoembolization, Therapeutic (adverse effects, methods)
• Chi-Square Distribution
• Cohort Studies
• Disease-Free Survival
• Female
• Humans
• Infusions, Intra-Arterial
• Kaplan-Meier Estimate
• Liver Neoplasms (mortality, pathology, surgery, therapy)
• Male
• Middle Aged
• Neoplasm Invasiveness (pathology)
• Neoplasm Staging
• Prognosis
• Retrospective Studies
• Risk Assessment
• Statistics, Nonparametric
• Survival Analysis
• Treatment Outcome