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Clinical Trial
. 2005 Aug;54(8):1151-6.
doi: 10.1136/gut.2004.045203.

Randomised controlled trial comparing percutaneous radiofrequency thermal ablation, percutaneous ethanol injection, and percutaneous acetic acid injection to treat hepatocellular carcinoma of 3 cm or less

S-M Lin  1 , C-J Lin, C-C Lin, C-W Hsu, Y-C Chen
Affiliations
Clinical Trial

Randomised controlled trial comparing percutaneous radiofrequency thermal ablation, percutaneous ethanol injection, and percutaneous acetic acid injection to treat hepatocellular carcinoma of 3 cm or less

S-M Lin et al. Gut. 2005 Aug.

Erratum in

  • Gut. 2005 Oct;54(10):1508

Abstract

Aims: The aim of this study was to compare the outcomes of radiofrequency thermal ablation (RFTA), percutaneous ethanol injection (PEI), and percutaneous acetic acid injection (PAI) in the treatment of hepatocellular carcinoma (HCC).

Patients and methods: A total of 187 patients with HCCs of 3 cm or less were randomly assigned to RFTA (n = 62), PEI (n = 62), or PAI (n = 63). Tumour recurrence and survival rates were assessed.

Results: One, two, and three year local recurrence rates were 10%, 14%, and 14% in the RFTA group, 16%, 34%, and 34% in the PEI group, and 14%, 31%, and 31% in the PAI group (RFTA v PEI, p = 0.012; RFTA v PAI, p = 0.017). One, two, and three year survival rates were 93%, 81%, and 74% in the RFTA group, 88%, 66%, and 51% in the PEI group, and 90%, 67%, and 53% in the PAI group (RFTA v PEI, p = 0.031; RFTA v PAI, p = 0.038). One, two, and three year cancer free survival rates were 74%, 60%, and 43% in the RFTA group, 70%, 41%, and 21% in the PEI group, and 71%, 43%, and 23% in the PAI group (RFTA v PEI, p = 0.038; RFTA v PAI, p = 0.041). Tumour size, tumour differentiation, and treatment methods (RFTA v PEI and PAI) were significant factors for local recurrence, overall survival, and cancer free survival. Major complications occurred in 4.8% of patients (two with haemothorax, one gastric perforation) in the RFTA group and in none in two other groups (RFTA v PEI and PAI, p = 0.035).

Conclusions: RFTA was superior to PEI and PAI with respect to local recurrence, overall survival, and cancer free survival rates, but RFTA also caused more major complications.

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Figures

Figure 1
Figure 1
Comparison of local recurrence rate for the main tumour in the radiofrequency thermal ablation (RFTA), percutaneous ethanol injection (PEI), and percutaneous acetic acid injection (PAI) groups. Local recurrence rate was significantly lower in the RFTA group compared with the two other groups (RFTA v PEI, p = 0.012; RFTA v PAI, p = 0.017). Differences between the three groups were significant (p = 0.015).
Figure 2
Figure 2
Comparison of overall survival rate in the radiofrequency thermal ablation (RFTA), percutaneous ethanol injection (PEI), and percutaneous acetic acid injection (PAI) groups. Overall survival rate was significantly higher in the RFTA group compared with two other groups (RFTA v PEI, p = 0.031; RFTA v PAI, p = 0.038). Differences between the three groups were significant (p = 0.033).
Figure 3
Figure 3
Comparison of cancer free survival rate in the radiofrequency thermal ablation (RFTA), percutaneous ethanol injection (PEI), and percutaneous acetic acid injection (PAI) groups. Cancer free survival rate was significantly higher in the RFTA group compared with the two other groups (RFTA v PEI group, p = 0.038; RFTA v PAI, p = 0.041). Differences between the three groups were significant (p = 0.039).
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Comment in

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