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

Abstract

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. 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 3mm or larger in axial diameter. Local tumor progression (LTP) rates were compared by propensity score matching. Procedure-related complications were also assessed. The median follow-up was 23months (range 2-45months). Twenty-five patients were matched in each group. The cumulative LTP rates at 1 and 3years 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. In patients with perivascular HCC, cryoablation is an effective alternative treatment compared with RF ablation regarding local tumor control and complications. Level 4 (retrospective case-control study).