Abstract | BACKGROUND AND PURPOSE: METHODS: We retrospectively analyzed consecutive treatment-naïve patients who received curative RFA for HCC within Milan criteria from January 2016 to December 2018. Patients who underwent either IoCT-guided RFA (IoCT group) or US-guided RFA (US group) were included. Various clinical factors, including tumor location, were adjusted with a 1:1 propensity score matching. Subsequently, the cumulative incidence rates for recurrence and hazard ratios for survival were calculated. RESULTS: We included 184 (37.9%) and 301 (62.1%) patients who received IoCT- and US-guided RFA, respectively. Before propensity score matching, IoCT guidance was significantly associated with multiple tumors, higher body mass index, lower albumin level, and tumors located at S8. After matching, the 1-, 2-, and 3-year local tumor progression rates of the IoCT group were significantly lower than those of the US group (4.4%, 6.9%, and 7.5% vs. 14.4%, 16.3%, and 16.3%, respectively, at p = 0.002, 0.009, and 0.016, respectively). In univariate analyses and multivariate analyses that adjusted for clinical and tumor location-related parameters, the IoCT group had better recurrence-free survival (hazard ratio = 0.581, 95% confidence interval 0.375-0.899) than those with US guidance but not overall survival. CONCLUSION: IoCT-guided RFA had a lower local tumor progression rate and better recurrence-free survival than did US-guided RFA for HCC within the Milan criteria. CT-guide RFA is a safe and effective alternative to US-guided with similar overall survival. IoCT-guided RFA might have a better local tumor control than US-guided. IoCT-guided RFA may be more suitable for male patients, aged < 70 years, a single tumor measuring 2-5 cm, and a tumor located at the subdiaphragmatic/subcardiac region.
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Authors | Chih-Horng Wu, Po-Chin Liang, Tung-Hung Su, Ming-Chi Lin, Yu-Hsuan Chang, Tiffany Ting-Fang Shih, Jia-Horng Kao |
Journal | Hepatology international
(Hepatol Int)
Vol. 15
Issue 5
Pg. 1247-1257
(Oct 2021)
ISSN: 1936-0541 [Electronic] United States |
PMID | 34338971
(Publication Type: Journal Article)
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Copyright | © 2021. Asian Pacific Association for the Study of the Liver. |
Chemical References |
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Topics |
- Carcinoma, Hepatocellular
(diagnostic imaging, surgery)
- Catheter Ablation
- Humans
- Iodized Oil
- Liver Neoplasms
(diagnostic imaging, surgery)
- Male
- Radiofrequency Ablation
- Retrospective Studies
- Tomography, X-Ray Computed
- Treatment Outcome
- Ultrasonography, Interventional
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