A case-control study comparing percutaneous radiofrequency ablation alone or combined with transcatheter arterial chemoembolization for hepatocellular carcinoma

Abstract

Aims: To assess whether combining percutaneous radiofrequency ablation (PRFA) with transcatheter arterial chemoembolization (TACE) was better than PRFA alone for hepatocellular carcinoma (HCC).

Materials and methods: One hundered twenty patients (with a solitary HCC<or=7.0 cm in diameter or multiple HCC (<or=3), each <or=3.0 cm in diameter) treated with PRFA combined with TACE were compared with 120 well-matched controls selected from a pool of 652 patients who received PRFA alone during the study period.

Results: The 1-, 2-, 3-, 5-year overall survival rates for the TACE-PRFA and PRFA groups were 93%, 83%, 75%, 50%, and 89%, 76%, 64%, 42%, respectively (p=.045). Subgroup analyses showed the survival for the TACE-PRFA group was better than the PRFA group for tumors >5.0 cm (p=.031) and for multiple tumors (p=.032), but not for tumors <or=5.0 cm (p=.319) and for solitary tumor (p=.128). The 1-, 2-, 3-, 5-year progression free survival (PFS) for the TACE-PRFA and PRFA groups was 90%, 76%, 63%, 42%, and 76%, 60%, 47%, 30%, respectively (p=.002). Child-pugh class, Diameter of tumor and hepatitis B surface antigen (HBsAg) were significant prognostic factors.

Conclusion: Patients treated with TACE-PRFA had better overall survivals than PRFA alone, but only in a subgroup of patients with tumor >5 cm or multiple tumors.