Comparable survival in patients with unresectable hepatocellular carcinoma treated by radiofrequency ablation or transarterial chemoembolization

Hypothesis: The survival benefits of radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) are similar for patients with unresectable hepatocellular carcinoma amenable to either treatment. Design: Retrospective comparative study. Setting: Tertiary care institution. Patients: From February 22,2001, to March 10, 2004,91 patients with unresectable hepatocellular carcinoma (tumor diameter <5 cm and <4 tumor nodules) treated by either TACE or RFA were analyzed from a prospective database. Main Outcome Measures: The treatment-related morbidity, mortality, overall survival, and time to disease progression. Results: Forty patients received TACE and 51 patients received RFA during the study period. Demographic data were comparable in both groups of patients. The treatment-related morbidities of TACE and RFA were 10% and 28%, respectively (P=.04). There was no treatment-related mortality in either group. There was 1 patient (2%) with complete tumor remission in the TACE group, and the complete ablation rate in the RFA group was 96%. The time to disease progression was similar in both groups (P=.95). The overall survival rates at 1 and 2 years were 80% and 58%, respectively, in the TACE group and 82% and 72%, respectively, in the RFA group (P=.21). Conclusions: The overall survival and time for disease progression were similar in both groups of patients. In terms of the survival result, the efficacies of RFA and TACE were comparable for patients with unresectable hepatocellular carcinoma.