Abstract

The aim of this study was to investigate the therapeutic efficacy of percutaneous radiofrequency (RF) ablation versus microwave (MW) ablation for hepatocellular carcinoma (HCC) measuring ≤5 cm in greatest diameter. From January 2006 to December 2006, 78 patients had undergone RF ablation whereas 77 had undergone MW ablation. Complete ablation (CA), local tumour progression (LTP) and distant recurrence (DR) were compared. The overall survival curves were calculated with the Kaplan-Meier technique and compared with the log-rank test. The CA rate was 83.4% (78/93) for RF ablation and 86.7%(91/105 for MW ablation. The LTP rate was 11.8% (11/93) for RF ablation and 10.5% (11/105) for MW ablation. DR was found in 51 (65.4%) in the RF ablation and 62 (80.5%) in the MW ablation. There was no significant difference in the 1-, 3-, and 5-year overall survival rates (P = 0.780) and the 1-, 3-, and 5-year disease-free survival rates (P = 0.123) between RF and MW ablation. At subgroup analyses, for patients with tumors ≤3.0 cm, there was no significant difference in the 1-, 3-, and 5-year overall survival rates (P = 0.067) and the corresponding disease-free survival rates(P = 0.849). For patients with tumor diameters of 3.1–5.0 cm, the 1-, 3-, and 5-year overall survival rates were 87.1%, 61.3%, and 40.1% for RF ablation and 85.4%, 36.6%, and 22% for MW ablation, with no significant difference (P = 0.068). The corresponding disease-free survival rates were 74.2%, 54.8%, and 45.2% for the RF ablation group and 53.3%, 26.8%, and 17.1% for the MW ablation group. The disease-free survival curve for the RF ablation group was significantly better than that for the MW ablation group (P = 0.018). RF ablation and MW ablation are both effective methods in treating hepatocellular carcinomas, with no significant differences in CA, LTP, DR, and overall survival.

Highlights

  • Hepatocellular carcinoma (HCC) is the sixth most common type of cancer and the third leading cause of cancer-related death [1]

  • There was no significant difference between the two groups in sex, age, tumor size, a-fetoprotein level, hepatitis B surface antigen, and Child-Pugh class

  • Comparison the therapeutic efficacy of percutaneous RF ablation versus MW ablation for hepatocellular carcinoma(HCC) measuring #5 cm in greatest diameter revealed that no significant differences in complete ablation (CA), Local tumor progression (LTP), distant recurrence (DR), complication rates, and overall survival between the two groups

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Summary

Introduction

Hepatocellular carcinoma (HCC) is the sixth most common type of cancer and the third leading cause of cancer-related death [1]. Hepatectomy offers the best outcomes for patients with HCC [2,3]. When hepatectomy options are precluded, image-guided tumor ablation therapy is recommended as the most appropriate therapeutic choice and is considered a potentially curative treatment in properly selected candidates [4,6]. In the past two decades, thermal ablation therapy by using energy sources has been increasingly accepted due to the advantages of greater capacity to devitalize HCC with fewer treatment sessions [7,8]. Radiofrequency (RF) ablation has been considered to be the most common thermal ablation modality worldwide for early stage HCC in patients, with 80–95% complete tumour necrosis and 33–57% 5-year survival [9]. Studies in which MW ablation was used to treat HCC #5 cm have reported 29–68.6% 5-year survival [13,14]

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