title: Medium-sized (3.1-5.0 cm) hepatocellular carcinoma: transarterial chemoembolization plus radiofrequency ablation versus radiofrequency ablation alone.
abstract: OBJECTIVE
  This study was designed to retrospectively compare the effectiveness of combined transarterial chemoembolization (TACE) plus radiofrequency ablation (RFA) with that of RFA alone in patients with medium-sized (3.1-5.0 cm) hepatocellular carcinoma (HCC).
  
  
  METHODS
  From March 2000 to April 2010, 57 patients, each with a single medium-sized HCC, were treated with combined TACE and RFA, and 66 were treated with RFA alone.
  
  
  RESULTS
  During follow-up (mean, 42.5 ± 33.2 months; range, 2.6-126.2 months), local tumor progression was observed in 40% of treated lesions in the combined treatment group and in 70% in the RFA-alone group. The 1-, 3-, 5-, and 7-year local tumor progression rates were significantly lower in the TACE + RFA group (9%, 40%, 55%, and 66%, respectively) than in the RFA-alone group (45%, 76%, 86%, and 89%, respectively; P < 0.001). Multivariate analysis showed that treatment allocation (odds ratio [OR], 1.78; P = 0.016) and Child-Pugh class (OR, 1.96; P = 0.008) were significant independent factors associated with patient survival. The rates of major complications were 0% for the combined treatment group and 3% for the RFA-alone group.
  
  
  CONCLUSIONS
  The combination of TACE and RFA is safe and provides better local tumor control than RFA alone for the treatment of patients with medium-sized HCC. Our multivariate analysis showed that RFA-alone treatment and Child-Pugh class B were poor independent factors for determining the patient survival period.
authors: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. m1fenew@daum.net
authors: Jin Hyoung
authors: JH
authors: Kim
authors: Hyung Jin
authors: HJ
authors: Won
authors: Yong Moon
authors: YM
authors: Shin
authors: Sung Hee
authors: SH
authors: Kim
authors: Hyun-Ki
authors: HK
authors: Yoon
authors: Kyu-Bo
authors: KB
authors: Sung
authors: Pyo Nyun
authors: PN
authors: Kim
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D002945:Cisplatin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin