Early-stage hepatocellular carcinoma: Radiofrequency ablation combined with Chemoembolization versus hepatectomy

Purpose: To retrospectively evaluate the long-term results of radio-frequency ( RF) ablation combined with chemoembolization ( combination therapy) as compared with hepatectomy for the treatment of early-stage hepatocellular carcinoma ( HCC). Materials and Methods: The study was approved by the institutional review board, and informed consent was waived. Patients with early-stage HCC were included if they underwent either combination therapy or hepatectomy and met the following inclusion criteria: no previous treatment for HCC, three or fewer tumors with a maximum diameter of 3 cm or less each or a single tumor with a maximum diameter of 5 cm or less, Child-Pugh class A liver profile, no vascular invasion, and no extrahepatic metastases. The primary end-point was overall survival, and the secondary endpoint was recurrence-free survival. Results: One hundred four patients ( mean age, 66.5 years +/- 8.7 [ standard deviation]; 79 men, 25 women) underwent combination therapy, and 62 patients ( mean age, 64.5 years +/- 9.6; 51 men, 11 women) underwent hepatectomy. The 1-, 3-, and 5- year overall survival rates following combination therapy ( 98%, 94%, and 75%, respectively) were similar ( P =.87) to those following hepatectomy ( 97%, 93%, and 81%, respectively). The 1-, 3-, and 5- year recurrence-free survival rates were also comparable ( P =.70) for combination therapy ( 92%, 64%, and 27%, respectively) and hepatectomy ( 89%, 69%, and 26%, respectively). Conclusion: RF ablation combined with chemoembolization in patients with early-stage HCC provides overall and disease-free survival rates similar to those achieved by hepatectomy. (C) RSNA, 2008.