Korean J Intern Med.  2016 Mar;31(2):242-252. 10.3904/kjim.2015.112.

Combination transarterial chemoembolization and radiofrequency ablation therapy for early hepatocellular carcinoma

• Song MJ
• Bae SH
• Lee JS
• Lee SW
• Song DS
• You CR
• Choi JY
• Yoon SK

• KMID: 2373799
• DOI: http://doi.org/10.3904/kjim.2015.112

Abstract

BACKGROUND/AIMS
We compared the recurrence of hepatocellular carcinoma (HCC) and the survival of patients who received radiofrequency ablation (RFA) after transarterial chemoembolization (TACE) with patients treated with TACE or RFA alone.
METHODS
This study included 201 patients with HCC, who were consecutively enrolled at Seoul St. Mary's Hospital between December 2004 and February 2010. Inclusion criteria were a single HCC < or = 5.0 cm or up to three HCCs < or = 3.0 cm. We used a propensity score model to compare HCC patients (n = 87) who received RFA after TACE (TACE + RFA) with those who received TACE (n = 71) or RFA alone (n = 43).
RESULTS
The median follow-up period was 33.3 months (range, 6.8 to 80.9). The TACE + RFA group showed significantly lower local recurrence than the RFA or TACE groups (hazard ratio [HR], 0.309; 95% confidence interval [CI], 0.130 to 0.736; p = 0.008; and HR, 0.352; 95% CI, 0.158 to 0.787; p = 0.011, respectively). The overall survival was significantly better in the TACE + RFA group compared to the RFA group (HR, 0.422; 95% CI, 0.185 to 0.964; p = 0.041). However, the survival benefit was not different between the TACE + RFA and TACE groups (p = 0.124). Subgroup analysis showed that among patients with a tumor size < 3 cm, the TACE + RFA group had significantly better long-term survival than those in the TACE or RFA groups (p = 0.017, p = 0.004, respectively).
CONCLUSIONS
TACE + RFA combination treatment showed favorable local recurrence and better overall survival rates in early-stage HCC patients. Patients with tumors < 3 cm are likely to benefit more from TACE + RFA combination treatment. Additional studies are needed for the selection of suitable HCC patients for TACE + RFA treatment.

Keyword

Radiofrequency ablation; Transarterial chemoembolization; Recurrence; Overall survival

MeSH Terms

Adult
Aged
Aged, 80 and over
Carcinoma, Hepatocellular/mortality/pathology/*therapy
*Catheter Ablation/adverse effects/mortality
*Chemoembolization, Therapeutic/adverse effects/mortality
Chemotherapy, Adjuvant
Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Liver Neoplasms/mortality/pathology/*therapy
Male
Middle Aged
*Neoadjuvant Therapy/adverse effects/mortality
Neoplasm Recurrence, Local
Neoplasm Staging
Patient Selection
Proportional Hazards Models
Republic of Korea
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
Tumor Burden
Young Adult