Combination therapy with radiofrequency ablation and transcatheter chemoembolization for the treatment of hepatocellular carcinoma: Short-term recurrences and survival

Abstract

To evaluate short-term clinical results of radiofrequency (RF) ablation combined with transcatheter chemoembolization for the treatment of hepatocellular carcinoma (HCC) and to identify factors having influence on early intrahepatic recurrence. Sixty-four patients with 92 HCC lesions underwent RF ablation within 2 weeks after chemoembolization. The maximum tumor size was small (</=3 cm) in 36 patients, intermediate (3.1-5 cm) in 22 patients, and large (5.1-8.5 cm) in 6 patients. Tumors were solitary in 42 patients and multiple (2 or 3) in 22 patients. Factors affecting intrahepatic recurrence were evaluated by univariate and multivariate analyses. Intrahepatic recurrences were found in 13 patients (20%, 13/64) during the mean follow-up period of 18 months. Recurrences were found in the untreated liver in 11 patients and in both untreated liver and treated lesion in 2 patients. The cumulative intrahepatic recurrence rates were 15% at 1 year and 43% at 2 years. In the univariate analysis, multiple tumor burden and large tumor size (>5 cm) were significantly linked with higher probability of early intrahepatic recurrence. In the multivariate analysis, tumor number was the only independent factor having significant impact on early intrahepatic recurrence. The estimated 1- and 2-year survival rates were 100% and 93%, respectively. This combined therapy showed good early therapeutic effects on treated lesions and survival. Tumor number and maximum tumor size are important factors for early intrahepatic recurrence.