RF Ablation Versus Cryoablation for Small Perivascular Hepatocellular Carcinoma: Propensity Score Analyses of Mid-Term Outcomes

Purpose This study aimed to compare radiofrequency (RF) ablation with cryoablation in patients with perivascular hepatocellular carcinoma (HCC) and evaluate the mid-term outcomes of both therapies. Materials and Methods Between January 2015 and April 2018, 111 patients who underwent percutaneous cryoablation (n = 61) or RF ablation (n = 50) for a single perivascular HCC were included. Perivascular HCC was defined as the presence of contacting peritumoral hepatic vessels that were 3 mm or larger in axial diameter. Local tumor progression (LTP) rates were compared by propensity score matching. Procedure-related complications were also assessed. Results The median follow-up was 23 months (range 2-45 months). Twenty-five patients were matched in each group. The cumulative LTP rates at 1 and 3 years were 8.3% and 17.3% in the cryoablation group and 8.7% and 26.1% in the RF ablation group, with no significant difference (p = 0.379). Although there were no significant differences between the two groups, vascular thrombosis (16.0% vs. 9.8%, p = 0.493) and hepatic infarction (12.0% vs. 3.3%, p = 0.137) more frequently occurred in the RF ablation group than in the cryoablation group. Conclusion In patients with perivascular HCC, cryoablation is an effective alternative treatment compared with RF ablation regarding local tumor control and complications.