Small hepatocellular carcinoma: Is radiofrequency ablation combined with transcatheter arterial chemoembolization more effective than radiofrequency ablation alone for treatment?
Shibata T et al. - In a study to prospectively compare combined radiofrequency ablation and transcatheter arterial chemoembolization (TACE) with radiofrequency ablation alone for treatment of small (3 cm) hepatocellular carcinomas (HCCs), it appears that combined radiofrequency ablation plus TACE and radiofrequency ablation alone have equivalent effectiveness for treatment of small HCCs, so the combination treatment may not be necessary. Methods- 89 pts with 93 HCC nodules 0.8–3.0 cm in diameter were randomly treated with combined radiofrequency ablation and TACE (46 pts with 49 nodules) or with radiofrequency ablation alone (43 pts with 44 nodules).
- Patients were followed up for 9–68 mos.
- Rates of local tumor progression (LTP), overall survival (OS), local progression-free survival (PFS), and event-free survival (EFS) were evaluated by using the Kaplan-Meier method.
Results- 1-, 2-, 3-, and 4-yr rates of LTP, OS, local PFS, and recurrence-free survival were as follows: LTP rates were 14.4%, 17.6%, 17.6%, and 17.6%, respectively, in combined treatment group and 11.4%, 14.4%, 14.4%, and 14.4%, respectively, in radiofrequency ablation group.
- OS rates were 100%, 100%, 84.8%, and 72.7%, respectively, in combined treatment group and 100%, 88.8%, 84.5%, and 74.0%, respectively, in radiofrequency ablation group.
- Local PFS rates were 84.6%, 81.1%, 69.7%, and 55.8%, respectively, in combined treatment group and 88.4%, 74.1%, 74.1%, and 61.7%, respectively, in radiofrequency ablation group.
- EFS rates were 71.3%, 59.9%, 48.8%, and 36.6%, respectively, in combined treatment group and 74.3%, 52.4%, 29.7%, and 29.7%, respectively, in radiofrequency ablation group.
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