title: [Comparison of radiofrequency ablation and transarterial chemoembolization for the treatment of a single hepatocellular carcinoma smaller than 4 cm].
abstract: OBJECTIVE
  Radiofrequency ablation (RFA) is an established curative therapeutic modality for unresectable hepatocellular carcinoma (HCC), and transarterial chemoembolization (TACE) has been used as a palliative treatment for inoperable HCC. It is still unknown whether RFA and TACE are equally effective for improving the survival of patients with unresectable HCC that is amenable to either treatment. The aim of this retrospective study was to compare the clinical impacts of two treatments, and analyze the prognostic factors for recurrence and survival.
  
  
  METHODS
  Ninety-three patients with a single HCC smaller than 4 cm who showed complete responses (complete ablation or complete lipiodol tagging) after treatment with RFA (n=43) or TACE (n=50) between January 2002 and February 2009 were investigated. Univariate and multivariate analyses were performed for 13 potential prognostic factors using the Cox proportional-hazards model.
  
  
  RESULTS
  The time-to-recurrence rates at 1, 2, and 3 years after treatment were 32.9%, 44.3%, and 55.4%, respectively, for the RFA group, and 42%, 68.3%, 71.7% for the TACE group. The probability of survival at 1, 2, and 3 years was 97.7%, 77.4%, and 63.1%, respectively, for the RFA group, and 95.9%, 76.1%, and 60.2% for the TACE group. The time-to-recurrence and overall survival rates did not differ significantly between the two treatment groups. A multivariate Cox proportional-hazards model revealed that a tumor size larger than 3 cm and lower serum albumin levels were independent risk factors for recurrence, and that being male, being seropositive for hepatitis B surface antigen, and having a higher serum albumin level were independent favorable prognostic factors for survival.
  
  
  CONCLUSIONS
  TACE and RFA exhibited similar therapeutic effects in terms of recurrence and survival for patients with a single HCC smaller than 4 cm, if they could exhibited complete responses.
authors.affiliation: Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Min Jae
authors.initials: MJ
authors.lastname: Yang
authors.forename: So Yun
authors.initials: SY
authors.lastname: An
authors.forename: Eun Joon
authors.initials: EJ
authors.lastname: Moon
authors.forename: Min Suk
authors.initials: MS
authors.lastname: Lee
authors.forename: Joo An
authors.initials: JA
authors.lastname: Hwang
authors.forename: Jae Youn
authors.initials: JY
authors.lastname: Cheong
authors.forename: Je Hwan
authors.initials: JH
authors.lastname: Won
authors.forename: Jai Keun
authors.initials: JK
authors.lastname: Kim
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Wang
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Cho
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D003627:Data Interpretation, Statistical; D005260:Female; D006509:Hepatitis B / Q000150:complications; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index; D012737:Sex Factors; D015996:Survival Rate
chemical_list: D012709:Serum Albumin