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A randomized Comparison of Radiofrequency Thermal Ablation and Percutaneous Ethanol Injection for the Treatment of Small Hepatocellular Carcinoma

Li Liu, MD

University of Pennsylvania Cancer
Ultima Vez Modificado: 14 de mayo del 2001

Presenter: H. P. Allgaier/M. Olschewski
Affiliation: University of Pisa, Pisa, Italy

Background:

Hepatocellular carcinoma (HCC) is one of the major malignancies worldwide. Approximately 80% of patients are inoperable at the time of diagnosis. The treatment of choice for hepatocellular carcinoma remains surgical resection or liver transplantation, in carefully selected cases. In patients with hepatocellular carcinoma not amenable to surgical intervention a variety of different therapeutic interventions have been investigated. These include transarterial chemoembolization, percutaneous ethanol injection (PEI), and percutaneous radiofrequency thermal ablation (RFTA).

Materials and Methods:

• This was a randomized study compared the efficacy and safety of RFTA in comparison to PEI.
• A total of 142 tumors in 102 patients were treated with either PEI (n=50) or RFTA (n=52).
• None of the patients had extrohepatic metastasis.
• The study endpoints included total mortality, local recurrence-free, and event-free survival.

Results:

With a mean follow-up of approximate 2219 months,
• 2-year survival rates were 88% and 96% in the PEI group and RFTA group, respectively (p=0.138).
• 2-year local recurrence-free survival rates were 62% and 96% in the PEI group and RFTA group, respectively (p=0.0016).
• 2-year event-free survival were 43% and 62% in the PEI group and RFTA group, respectively (p=0.012).
• Complications were comparable between the two treatment groups.

Authors' Conclusions

• RFTA appeared to be a more effective ablative treatment for HCCs than PEI in terms of local recurrence-free and event-free survival.
• Short-term survival and safety of RFTA is similar to OEI.superior to PEI.

Clinical/Scientific Implications:

• Hepatocellular carcinoma remains a most formidable disease.
• The main challenge facing the research community over the next decade is to prioritise the most promising treatments and take these forward into multicenter controlled trials.