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≤7.0cm in diameter or multiple HCC (≤3), each ≤3.0cm 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 >5.0cm (p=.031) and for multiple tumors (p=.032), but not for tumors ≤5.0cm (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 >5cm or multiple tumors.

Keywords: Percutaneous radiofrequency ablation, Transcatheter arterial chemoembolization, Hepatocellular carcinoma, Progression free survival, Overall survival