Midterm outcomes in patients with intermediate-sized hepatocellular carcinoma: a randomized controlled trial for determining the efficacy of radiofrequency ablation combined with transcatheter arterial chemoembolization.
BACKGROUND
To improve the efficacy of radiofrequency ablation (RFA) for the treatment of intermediate-sized hepatocellular carcinomas (HCCs), the authors compared RFA combined with transcatheter arterial chemoembolization (TACE) to RFA alone.


METHODS
The authors randomly assigned 37 patients with solitary HCCs (diameter, 3.1-5.0 cm in the greatest dimension) to 2 groups: the TACE-RFA group, in which the patients received TACE followed by RFA on the same day, and the RFA group, in which the patients received only RFA.


RESULTS
Technical success was achieved after 1.4±0.5 RFA sessions in the RFA group and after 1.1±0.2 RFA sessions in the TACE-RFA group (P<.01). The mean diameters of the longer and shorter axes of the RFA-induced ablated areas were 50±8.0 mm and 41±7.1 mm, respectively, in the RFA group and 58±13.2 mm and 50±11.3 mm, respectively, in the TACE-RFA group; the mean diameters of the shorter axes were significantly different (P=.012). The rates of local tumor progression at the end of the third year in the RFA and TACE-RFA groups were 39% and 6%, respectively (P=.012). The 3-year survival rates of the patients in the RFA and TACE-RFA groups were 80% and 93%, respectively (P=.369).


CONCLUSIONS
In patients with intermediate-sized HCCs, RFA combined with TACE is more effective than RFA alone for extending the ablated area in fewer treatment sessions and for decreasing the local tumor progression rate.
Morimoto
Manabu
M
Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan. morimoto@urahp.yokohama-cu.ac.jp
Numata
Kazushi
K
Kondou
Masaaki
M
Nozaki
Akito
A
Morita
Satoshi
S
Tanaka
Katsuaki
K
D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy / Q000009:adverse effects; D018450:Disease Progression; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome