title: Radiofrequency ablation combined with transarterial chemoembolization for intermediate hepatocellular carcinoma.
abstract: OBJECTIVE
  Radiofrequency ablation therapy (RFA) combined with transarterial chemoembolization (TACE) (combination therapy) is effective for early-stage hepatocellular carcinoma (HCC). The aim of this study was to compare the long-term effects of combination therapy with supportive care alone for intermediate HCC.
  
  
  METHODS
  The study included 58 patients with intermediate HCC who received combination therapy (n = 34) or supportive care alone (n = 24). The inclusion criteria were a single nodule of more than 50 mm in diameter or two to three nodules, each measuring more than 30 mm in diameter, or more than three nodules, no vascular invasion and no extrahepatic metastasis.
  
  
  RESULTS
  The overall survival rates at 1, 2, 3 and 5 years of the combination therapy group (91%, 65%, 53% and 27%, respectively) were significantly better (P < 0.0001) than those of the supportive care group (42%, 8%, 8% and 0%, respectively). Multivariate analysis identified treatment modality (combination therapy vs supportive care alone: P < 0.0001, risk ratio [RR] = 4.290 [95% confidence interval [CI] = 2.157-8.529]) and serum α-fetoprotein (P = 0.017, RR = 2.318 [95% CI = 1.166-4.610]) as independent and significant factors of overall survival.
  
  
  CONCLUSIONS
  The combination of TACE and RFA is a safe and effective therapy in patients with intermediate HCC.
authors.affiliation: Department of Internal Medicine, Yokokura Hospital, Yufu, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Tanaka
authors.forename: Eiji
authors.initials: E
authors.lastname: Ando
authors.forename: Shigeo
authors.initials: S
authors.lastname: Simose
authors.forename: Maisa
authors.initials: M
authors.lastname: Hori
authors.forename: Kei
authors.initials: K
authors.lastname: Kuraoka
authors.forename: Miki
authors.initials: M
authors.lastname: Ohno
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yutani
authors.forename: Kazunori
authors.initials: K
authors.lastname: Harada
authors.forename: Michio
authors.initials: M
authors.lastname: Sata
keywords: intermediate hepatocellular carcinoma; radiofrequency ablation; transarterial chemoembolization