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Combined percutaneous radiofrequency ablation and ethanol injection versus hepatic resection for 2.1-5.0 cm solitary hepatocellular carcinoma: a retrospective comparative multicentre study.

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Title: Combined percutaneous radiofrequency ablation and ethanol injection versus hepatic resection for 2.1-5.0 cm solitary hepatocellular carcinoma: a retrospective comparative multicentre study.
Authors: Chen, Shuling1, Peng, Zhenwei2,3, Lin, Manxia1, Chen, Zebin4, Hu, Wenjie4, Xie, Xiaoyan1, Liu, LongZhong5, Qian, Guojun6, Peng, Baogang4, Li, Bin3, Kuang, Ming1,4 kuangm@mail.sysu.edu.cn
Source: European Radiology. Sep2018, Vol. 28 Issue 9, p3651-3660. 10p. 1 Diagram, 4 Charts, 2 Graphs.
Subjects: Liver cancer, Catheter ablation, Radio frequency therapy, Surgical excision, Retrospective studies, Tumor treatment, Cancer relapse, Combined modality therapy, Comparative studies, Ethanol, Hepatectomy, Hepatocellular carcinoma, Length of stay in hospitals, Injections, Liver tumors, Research methodology, Medical cooperation, Research, Research funding, Survival analysis (Biometry), Evaluation research, Treatment effectiveness, Therapeutics
Abstract: Objectives: To compare combined percutaneous radiofrequency ablation and ethanol injection (RFA-PEI) with hepatic resection (HR) in the treatment of resectable solitary hepatocellular carcinoma (HCC) with 2.1-5.0 cm diameter.Methods: From June 2009 to December 2015, 271 patients whom underwent RFA-PEI (n = 141) or HR (n = 130) in three centres were enrolled. The overall survival (OS) and recurrence-free survival (RFS) between groups were compared with Kaplan-Meier method and log-rank tests. Complications, hospital stay and cost were assessed.Results: The OS rates at 1, 3 and 5 years were 93.5%, 72.7%, 58.6% in RFA-PEI group and 82.3%, 57.5%, 51.8% in HR group (p = 0.021). The corresponding 1-, 3- and 5-year RFS rates were 65.8%, 41.3%, 34.3% in RFA-PEI group and 50.5%, 33.8%, 28.4% in HR group (p = 0.038). For patients with 2.1-3.0 cm tumours, the 1-, 3- and 5-year OS after RFA-PEI and HR were 98.0%, 82.3%, 74.2% and 89.4%, 65.1%, 61.9%, respectively (p = 0.024). The corresponding RFS were 79.6%, 54.7%, 45.1% in RFA-PEI group, and 57.6%, 43.9%, 31.7% in HR group, respectively (p = 0.020). RFA-PEI was superior to HR in major complication rates, length of hospital stay and cost (all p < 0.001).Conclusion: RFA-PEI had a survival benefit over HR in the treatment of solitary HCCs, especially for those with 2.1-3.0 cm in diameter.Key Points: • RFA-PEI provided superior survival to HR in solitary HCC with 2.1-5.0 cm in diameter. • RFA-PEI is superior to HR in complications, length of hospital stay and cost. • RFA-PEI might be an alternative treatment for solitary HCC within 5.0 cm in diameter. [ABSTRACT FROM AUTHOR]
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