title: Percutaneous ethanol injection therapy is comparable to radiofrequency ablation in hepatocellular carcinoma smaller than 1.5 cm: A matched case-control comparative analysis.
abstract: Although percutaneous ethanol injection therapy (PEIT) is best indicated for patients with small hepatocellular carcinoma (HCC), the survival advantage of PEIT needs confirmation in real-world practice. This study was approved by the institutional review board, and the informed consent was waived. The study included 535 consecutive patients with newly diagnosed early stage (Barcelona Clinic Liver Cancer [BCLC] 0 or A) HCC who underwent initially radiofrequency ablation (RFA) (n = 288) or PEIT (n = 247) from January 2005 to December 2010. The primary outcome was overall survival (OS) and the secondary outcome was time to progression (TTP). The longest diameters of tumors of the groups differed significantly and larger for RFA group than PEIT group (P < 0.001; 1.94 ± 0.65 cm vs 1.60 ± 0.50 cm, respectively). The 5-year OS rates were 72.2% in the RFA group and 67.4% in the PEIT group (P = 0.608). Even after propensity score matching, OS rates between the 2 groups were similar (5-year OS: 72.8% with RFA [n = 175] and 68.0% with PEIT [n = 175]) (P = 0.709). Moreover, in patients with the longest diameter of tumors (≤1.5 cm), multivariate Cox regression analysis showed that the treatment modality was not a significant prognosticator for OS (hazard ratio [HR], 1.690; 95% confidence interval [CI], 0.828-3.449; P = 0.149) and time to progression (HR, 1.160; 95% CI, 0.773-1.740; P = 0.474). PEIT and RFA show equal effectiveness in treating HCCs <1.5 cm in terms of OS and time to progression.
authors: Department of Internal Medicine and Liver Research Institute Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine CHA Gangnam Medical Center, Department of Internal Medicine, CHA University, Seoul, Republic of Korea.
authors: Su Jong
authors: SJ
authors: Yu
authors: Jung-Hwan
authors: JH
authors: Yoon
authors: Jeong Min
authors: JM
authors: Lee
authors: Jae Young
authors: JY
authors: Lee
authors: Se Hyung
authors: SH
authors: Kim
authors: Young Youn
authors: YY
authors: Cho
authors: Jeong-Ju
authors: JJ
authors: Yoo
authors: Minjong
authors: M
authors: Lee
authors: Dong Hyeon
authors: DH
authors: Lee
authors: Yuri
authors: Y
authors: Cho
authors: Eun Ju
authors: EJ
authors: Cho
authors: Jeong-Hoon
authors: JH
authors: Lee
authors: Yoon Jun
authors: YJ
authors: Kim
authors: Chung Yong
authors: CY
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000628:therapy*; D016022:Case-Control Studies; D017115:Catheter Ablation; D018450:Disease Progression; D018572:Disease-Free Survival; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D047368:Tumor Burden
chemical_list: D000891:Anti-Infective Agents, Local; D000431:Ethanol