title: Hepatocellular carcinoma ≤ 4 cm treated with radiofrequency ablation with or without percutaneous ethanol injection.
abstract: BACKGROUND
  To compare the survival of Chinese cirrhotic patients with hepatocellular carcinoma (HCC) ≤ 4 cm who underwent radiofrequency ablation (RFA) alone or a combination of RFA with percutaneous ethanol injection (PEI).
  
  
  METHODS
  Retrospective analysis was performed for 681 cases with HCC ≤ 4 cm who were treated with RFA alone or RFA combined with PEI (RFA + PEI) between 2004 and 2011.
  
  
  RESULTS
  As a result, 180 patients in each group were selected after propensity score matching (PSM). Higher overall survival (OS) and recurrence-free survival (RFS) rates were achieved by RFA + PEI compared with RFA alone (P = 0.019 and 0.009, respectively). The 1-, 3-, and 5-year cumulative OS rates were 78.0, 44.4, and 30.1% for patients in RFA group and 88.2, 58.0, and 41.1% for patients in RFA + PEI group, respectively. Besides, the 1-, 3-, and 5-year cumulative RFS rates were 77.0, 43.8, and 29.2% in RFA group, and 87.9, 57.6, and 38.4% in RFA + PEI group, respectively. The local recurrence, complete ablation and five-year mortality showed no distinct differences between RFA and RFA + PEI groups in three subgroups classified with tumor size. Moreover, Cox regression multivariate analysis results showed that sex and treatment approach were significantly related to OS, whereas sex, status of HBsAg, local recurrence, and number of tumor nodule were related to RFS.
  
  
  CONCLUSIONS
  Therefore, the combination of RFA and PEI yielded better OS and RFS rates than RFA alone for Chinese patients with HCC ≤ 4 cm.
authors.affiliation: Department of Health Statistics, School of Public Health, Weifang Medical College, Weifang, Shandong, China.
authors.forename: Fuyan
authors.initials: F
authors.lastname: Shi
authors.affiliation: Department of Health Statistics, School of Military Preventive Medicine, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Zhijun
authors.initials: Z
authors.lastname: Tan
authors.affiliation: Department of Mathematics, School of Public Health, Weifang Medical College, Weifang, Shandong, China.
authors.forename: Hongqing
authors.initials: H
authors.lastname: An
authors.affiliation: Department of Operating Room, Tumor Hospital, Jinan, Shandong, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Health Statistics, School of Military Preventive Medicine, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Yongyong
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Health Statistics, School of Public Health, Weifang Medical College, Weifang, Shandong, China.
authors.forename: Suzhen
authors.initials: S
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D002681:China; D018450:Disease Progression; D018572:Disease-Free Survival; D000431:Ethanol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D057216:Propensity Score; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D000431:Ethanol