Transcatheter arterial chemoembolization plus radiofrequency ablation therapy for early stage hepatocellular carcinoma: comparison with surgical resection

Cancer. 2010 Aug 1;116(15):3638-44. doi: 10.1002/cncr.25142.

Abstract

Background: Radiofrequency ablation (RFA) is becoming a well-known local therapy for hepatocellular carcinoma (HCC). Transcatheter arterial chemoembolization (TACE) is expected to enhance the effects of subsequent RFA by reducing arterial blood flow. However, the long-term efficacy of this combined therapy has not been elucidated. In this study, the survival rates of patients who received TACE combined with RFA (TACE + RFA) were compared with those of patients treated surgically.

Methods: The study included consecutive patients who received TACE+RFA or surgical resection as the initial curative treatment for HCC between 2000 and 2005 at Tokai University Hospital. Inclusion criteria were a single HCC<or=50 mm or up to 3 HCCs<or=30 mm, presence of cirrhosis classified as Child-Pugh class A, no vascular invasion, and no extrahepatic metastasis.

Results: Sixty-two patients (23 women, 39 men; aged 67.5+/-8.4 years [mean+/-standard deviation]) received TACE+RFA, and 55 patients (15 women, 40 men; aged 66.1+/-8.4 years) underwent surgical resection. Median follow-up periods were similar (50 months in the TACE+RFA group vs 49 months in the resection group). The probabilities of overall survival at 1, 3, and 5 years in the TACE+RFA group (100%, 94.8%, and 64.6%, respectively) were similar (P=.788) to those in the resection group (92.5%, 82.7%, and 76.9%, respectively). Two major RFA-related complications were observed (1.5%).

Conclusions: RFA combined with TACE is an efficient and safe treatment that provides overall survival rates similar to those achieved with surgical resection.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / surgery
  • Carcinoma, Hepatocellular / therapy*
  • Catheter Ablation* / adverse effects
  • Chemoembolization, Therapeutic* / adverse effects
  • Combined Modality Therapy
  • Female
  • Hepatectomy
  • Humans
  • Liver Neoplasms / mortality
  • Liver Neoplasms / surgery
  • Liver Neoplasms / therapy*
  • Male
  • Recurrence