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Published online before print May 20, 2003, 10.1148/radiol.2281020718
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(Radiology 2003;228:235-240.)
© RSNA, 2003

Vascular and Interventional Radiology

Small Hepatocellular Carcinoma in Cirrhosis: Randomized Comparison of Radio-frequency Thermal Ablation versus Percutaneous Ethanol Injection1

Riccardo A. Lencioni, MD, Hans-Peter Allgaier, MD, Dania Cioni, MD, Manfred Olschewski, MSc, Peter Deibert, MD, Laura Crocetti, MD, Holger Frings, MD, Joerg Laubenberger, MD, Ina Zuber, MD, Hubert E. Blum, MD and Carlo Bartolozzi, MD

1 From the Division of Diagnostic and Interventional Radiology, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Via Roma 67, I-56125 Pisa, Italy (R.A.L., D.C., L.C., C.B.); and the Departments of Medicine II (H.P.A., P.D., H.F., I.Z., H.E.B.), Medical Biometry (M.O.), and Radiology (J.L.), University Hospital Freiburg, Germany. From the 2001 RSNA scientific assembly. Received June 17, 2002; revision requested August 8; final revision received November 26; accepted December 19. Address correspondence to R.A.L. (e-mail: lencioni@do.med.unipi.it).

PURPOSE: To compare the effectiveness of radio-frequency (RF) thermal ablation with that of percutaneous ethanol injection (PEI) for the treatment of small hepatocellular carcinoma (HCC) in patients with cirrhosis.

MATERIALS AND METHODS: A series of 102 patients with hepatic cirrhosis and either single HCC 5 cm in diameter or smaller or as many as three HCCs each 3 cm or smaller (overall number of lesions, 142) randomly received either RF ablation (n = 52) or PEI (n = 50) as the sole first-line anticancer treatment. Mean follow-up was 22.9 months ± 9.4 (SD) in the RF group and 22.4 months ± 8.6 in the PEI group. Prognostic value of treatment techniques was assessed with univariate and multivariate Cox proportional hazards regression models.

RESULTS: One- and 2-year survival rates were 100% and 98% in the RF group and 96% and 88% in the PEI group, respectively (univariate relative risk [RR] = 0.20; 95% CI: 0.02, 1.69; P = .138). One- and 2-year local recurrence-free survival rates were 98% and 96% in the RF group and 83% and 62% in the PEI group, respectively (univariate RR = 0.17; 95% CI: 0.06, 0.51; P = .002). One- and 2-year event-free survival rates were 86% and 64% for the RF group and 77% and 43% for the PEI group, respectively (univariate RR = 0.48; 95% CI: 0.27, 0.85; P = .012). RF treatment was confirmed as an independent prognostic factor for local recurrence-free survival rates with multivariate analysis (adjusted RR = 0.20; 95% CI: 0.05, 0.73; P = .015).

CONCLUSION: RF ablation is superior to PEI with respect to local recurrence-free survival rates.

© RSNA, 2003

Index terms: Alcohol ablation, 761.1266 • Liver, cirrhosis, 76.794 • Liver, interventional procedures, 761.1266, 761.1269 • Liver neoplasms, 76.323 • Radiofrequency (RF) ablation, 761.1269




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