Early Stage Hepatocellular Carcinomas Not Feasible for Ultrasound-Guided Radiofrequency Ablation: Comparison of Transarterial Chemoembolization Alone and Combined Therapy with Transarterial Chemoembolization and Radiofrequency Ablation

• Published in: Cardiovascular and interventional radiology Vol. 39; no. 3; pp. 417 - 425
• Main Authors: Hyun, Dongho, Cho, Sung Ki, Shin, Sung Wook, Park, Kwang Bo, Park, Hong Suk, Choo, Sung Wook, Do, Young Soo, Choo, In-wook, Lee, Min Woo, Rhim, Hyunchul, Lim, Hyo Keun
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.03.2016; Springer Nature B.V
• Subjects: ABLATION; Aged; Carcinoma, Hepatocellular - therapy; Cardiology; Catheter Ablation; Chemoembolization, Therapeutic; Clinical Investigation; Combined Modality Therapy; COMBINED THERAPY; COMPARATIVE EVALUATIONS; Feasibility Studies; Female; HAZARDS; HEPATOMAS; Humans; Imaging; Liver Neoplasms - therapy; Male; Medicine; Medicine & Public Health; Middle Aged; MULTIVARIATE ANALYSIS; Nuclear Medicine; PATIENTS; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; RADIOWAVE RADIATION; Retrospective Studies; Treatment Outcome; Ultrasonography, Interventional; Ultrasound; Radiofrequency ablation; Hepatocellular carcinoma; Transarterial chemoembolization
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-015-1194-0

Purpose To report the results of combined therapy with transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) for early stage hepatocellular carcinoma (HCC) considered infeasible for ultrasound (US)-guided RFA in comparison with those of TACE monotherapy. Methods From January 2007 through December 2010, 91 patients with early or very early stage HCC infeasible for US-guided RFA received either TACE alone (TACE group; n  = 54) or TACE immediately followed by RFA (TACE–RFA group; n  = 37) as a first-line treatment. 1-month tumor response, time to progression (TTP), and overall survival (OS) rates were calculated. Univariate and multivariate analyses were performed to identify prognostic factors. Results TACE–RFA group showed a better 1-month tumor response than TACE group ( P  < .001). The mean TTP was 29.7 ± 3.4 months (95 % confidence intervals [CIs] 23.0–36.5) in TACE group and 34.9 ± 2.8 months (95 % CIs 29.4–40.4) in TACE–RFA group. TACE–RFA group had a significantly longer TTP ( P  = .014). Cumulative 1-, 2-, and 3-year OS rates in the TACE and TACE–RFA groups were 91, 79, and 71 % and 100, 97, and 93 %, respectively ( P  = .008). Initial treatment of TACE was found to be the only significant risk factor for tumor progression and OS in multivariate analysis. Conclusion TACE–RFA combination therapy appears superior to TACE monotherapy in terms of 1-month tumor response, TTP, and OS when performed for early stage HCC infeasible for US-guided RFA.