title: Transcatheter arterial chemoembolization plus radiofrequency ablation therapy for early stage hepatocellular carcinoma: comparison with surgical resection.
abstract: BACKGROUND
  Radiofrequency ablation (RFA) is becoming a well-known local therapy for hepatocellular carcinoma (HCC). Transcatheter arterial chemoembolization (TACE) is expected to enhance the effects of subsequent RFA by reducing arterial blood flow. However, the long-term efficacy of this combined therapy has not been elucidated. In this study, the survival rates of patients who received TACE combined with RFA (TACE + RFA) were compared with those of patients treated surgically.
  
  
  METHODS
  The study included consecutive patients who received TACE+RFA or surgical resection as the initial curative treatment for HCC between 2000 and 2005 at Tokai University Hospital. Inclusion criteria were a single HCC<or=50 mm or up to 3 HCCs<or=30 mm, presence of cirrhosis classified as Child-Pugh class A, no vascular invasion, and no extrahepatic metastasis.
  
  
  RESULTS
  Sixty-two patients (23 women, 39 men; aged 67.5+/-8.4 years [mean+/-standard deviation]) received TACE+RFA, and 55 patients (15 women, 40 men; aged 66.1+/-8.4 years) underwent surgical resection. Median follow-up periods were similar (50 months in the TACE+RFA group vs 49 months in the resection group). The probabilities of overall survival at 1, 3, and 5 years in the TACE+RFA group (100%, 94.8%, and 64.6%, respectively) were similar (P=.788) to those in the resection group (92.5%, 82.7%, and 76.9%, respectively). Two major RFA-related complications were observed (1.5%).
  
  
  CONCLUSIONS
  RFA combined with TACE is an efficient and safe treatment that provides overall survival rates similar to those achieved with surgical resection.
authors.affiliation: Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan. kagawa@is.icc.u-tokai.ac.jp
authors.forename: Tatehiro
authors.initials: T
authors.lastname: Kagawa
authors.forename: Jun
authors.initials: J
authors.lastname: Koizumi
authors.forename: Sei-ichiro
authors.initials: S
authors.lastname: Kojima
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Nagata
authors.forename: Makoto
authors.initials: M
authors.lastname: Numata
authors.forename: Norihito
authors.initials: N
authors.lastname: Watanabe
authors.forename: Tetsu
authors.initials: T
authors.lastname: Watanabe
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mine
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D017115:Catheter Ablation / Q000009:adverse effects; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D003131:Combined Modality Therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008297:Male; D012008:Recurrence