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Early-Stage Hepatocellular Carcinoma: Radiofrequency Ablation Combined with Chemoembolization versus Hepatectomy¹

¹ From the Department of Radiology (K.Y., A.N., H.T., K.T.), First Department of Surgery (H.Y., M.U., H.S., S.I.), and Department of Liver and Gastrointestinal Medicine (K.S., H.F.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan; and Department of Surgery, Kyoto University, Kyoto, Japan (S.U.). From the 2006 RSNA Annual Meeting. Received May 9, 2007; revision requested July 13; revision received July 17; accepted August 16; final version accepted October 4. Address correspondence to K.Y. (e-mail: yama{at}clin.medic.mie-u.ac.jp).

Purpose: To retrospectively evaluate the long-term results of radiofrequency (RF) ablation combined with chemoembolization (combination therapy) as compared with hepatectomy for the treatment of early-stage hepatocellular carcinoma (HCC).

Materials and Methods: The study was approved by the institutional review board, and informed consent was waived. Patients with early-stage HCC were included if they underwent either combination therapy or hepatectomy and met the following inclusion criteria: no previous treatment for HCC, three or fewer tumors with a maximum diameter of 3 cm or less each or a single tumor with a maximum diameter of 5 cm or less, Child-Pugh class A liver profile, no vascular invasion, and no extrahepatic metastases. The primary endpoint was overall survival, and the secondary endpoint was recurrence-free survival.

Results: One hundred four patients (mean age, 66.5 years ± 8.7 [standard deviation]; 79 men, 25 women) underwent combination therapy, and 62 patients (mean age, 64.5 years ± 9.6; 51 men, 11 women) underwent hepatectomy. The 1-, 3-, and 5-year overall survival rates following combination therapy (98%, 94%, and 75%, respectively) were similar (P = .87) to those following hepatectomy (97%, 93%, and 81%, respectively). The 1-, 3-, and 5-year recurrence-free survival rates were also comparable (P = .70) for combination therapy (92%, 64%, and 27%, respectively) and hepatectomy (89%, 69%, and 26%, respectively).

Conclusion: RF ablation combined with chemoembolization in patients with early-stage HCC provides overall and disease-free survival rates similar to those achieved by hepatectomy.

© RSNA, 2008