Midterm outcomes in patients with intermediate‐sized hepatocellular carcinoma

Abstract

BACKGROUND: To improve the efficacy of radiofrequency ablation (RFA) for the treatment of intermediate-sized hepatocellular carcinomas (HCCs), the authors compared RFA combined with transcatheter arterial chemoembolization (TACE) to RFA alone. METHODS: The authors randomly assigned 37 patients with solitary HCCs (diameter, 3.1-5.0 cm in the greatest dimension) to 2 groups: the TACE-RFA group, in which the patients received TACE followed by RFA on the same day, and the RFA group, in which the patients received only RFA. RESULTS: Technical success was achieved after 1.4±0.5 RFA sessions in the RFA group and after 1.1±0.2 RFA sessions in the TACE-RFA group (P<.01). The mean diameters of the longer and shorter axes of the RFA-induced ablated areas were 50±8.0 mm and 41±7.1 mm, respectively, in the RFA group and 58±13.2 mm and 50±11.3 mm, respectively, in the TACE-RFA group; the mean diameters of the shorter axes were significantly different (P=.012). The rates of local tumor progression at the end of the third year in the RFA and TACE-RFA groups were 39% and 6%, respectively (P=.012). The 3-year survival rates of the patients in the RFA and TACE-RFA groups were 80% and 93%, respectively (P=.369). CONCLUSIONS: In patients with intermediate-sized HCCs, RFA combined with TACE is more effective than RFA alone for extending the ablated area in fewer treatment sessions and for decreasing the local tumor progression rate.