title: Single hepatocellular carcinoma smaller than 2 cm: are ethanol injection and radiofrequency ablation equally effective?
abstract: OBJECTIVE
  The impact of radiofrequency ablation (RFA) and percutaneous ethanol injection (PEI) on survival in patients with small hepatocellular carcinoma (HCC) is unclear. We compared their efficacy in cirrhotics with single HCC ≤2 cm.
  
  
  METHODS
  Two hundred forty-four cirrhotics with single HCC ≤2 cm treated with PEI (108 cases) or RFA (136 cases) were enrolled in the study. Eighty-one patients in each group were selected for propensity score matching analysis.
  
  
  RESULTS
  The five-year survival was not significantly different (64.7% in PEI and 72.9% in RFA group) but the 5-year recurrence (73.3% in PEI and 49% in RFA group, p=0.023) and local tumor progression (49% in PEI and 30.1% in RFA group, p=0.018) were higher in the PEI group.
  
  
  CONCLUSIONS
  PEI and RFA are equally effective in treating HCCs smaller than 2 cm in terms of 5-year survival, despite higher cumulative and local recurrence rates, in patients treated with PEI.
authors.affiliation: Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy mpompili@rm.unicatt.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.affiliation: Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: De Matthaeis
authors.affiliation: Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Saviano
authors.affiliation: Internal Medicine and Gastroenterology, University of Naples, Naples, Italy.
authors.forename: Ilario
authors.initials: I
authors.lastname: De Sio
authors.affiliation: Diagnostic and Interventional Ultrasound Unit, Pineta Grande Hospital, Castel Volturno, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Francica
authors.affiliation: Department of Hepatology and Gastroenterology, San Giovanni Battista Hospital, Turin, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Brunello
authors.affiliation: Department of Hepatology and Gastroenterology, San Giovanni Battista Hospital, Turin, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cantamessa
authors.affiliation: IX Infectious Disease and Interventional Ultrasound Unit, D Cotugno Hospital, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Giorgio
authors.affiliation: IX Infectious Disease and Interventional Ultrasound Unit, D Cotugno Hospital, Naples, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Scognamiglio
authors.affiliation: Gastroenterology, G. da Saliceto Hospital, Piacenza, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Fornari
authors.affiliation: Gastroenterology, G. da Saliceto Hospital, Piacenza, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Giangregorio
authors.affiliation: Internal Medicine, S. Orsola Malpighi Hospital, Bologna, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Piscaglia
authors.affiliation: Internal Medicine, S. Orsola Malpighi Hospital, Bologna, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Gualandi
authors.affiliation: Gastroenterology, Belcolle Hospital, Viterbo, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Caturelli
authors.affiliation: Gastroenterology, Belcolle Hospital, Viterbo, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Roselli
authors.affiliation: Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Riccardi
authors.affiliation: Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Gian Ludovico
authors.initials: GL
authors.lastname: Rapaccini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D017115:Catheter Ablation; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D047368:Tumor Burden
chemical_list: D000970:Antineoplastic Agents; D000431:Ethanol
keywords: Hepatocellular carcinoma; liver cirrhosis; overall survival; percutaneous ethanol injection; radiofrequency ablation; tumor recurrence