Small hepatocellular carcinoma in cirrhosis: Randomized comparison of radio-frequency thermal ablation versus percutaneous ethanol injection

Riccardo A. Lencioni, Hans Peter Allgaier, Dania Cioni, Manfred Olschewski, Peter Deibert, Laura Crocetti, Holger Frings, Joerg Laubenberger, Ina Zuber, Hubert E. Blum, Carlo Bartolozzi

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818 Scopus citations

Abstract

PURPOSE: To compare the effectiveness of radio-frequency (RF) thermal ablation with that of percutaneous ethanol injection (PEI) for the treatment of small hepatocellular carcinoma (HCC) in patients with cirrhosis. MATERIALS AND METHODS: A series of 102 patients with hepatic cirrhosis and either single HCC 5 cm in diameter or smaller or as many as three HCCs each 3 cm or smaller (overall number of lesions, 142) randomly received either RF ablation (n = 52) or PEI (n = 50) as the sole first-line anticancer treatment. Mean follow-up was 22.9 months ± 9.4 (SD) in the RF group and 22.4 months ± 8.6 in the PEI group. Prognostic value of treatment techniques was assessed with univariate and multivariate Cox proportional hazards regression models. RESULTS: One- and 2-year survival rates were 100% and 98% in the RF group and 96% and 88% in the PEI group, respectively (univariate relative risk [RR] = 0.20; 95% CI: 0.02, 1.69; P = .138). One- and 2-year local recurrence-free survival rates were 98% and 96% in the RF group and 83% and 62% in the PEI group, respectively (univariate RR = 0.17; 95% CI: 0.06, 0.51; P = .002). One- and 2-year event-free survival rates were 86% and 64% for the RF group and 77% and 43% for the PEI group, respectively (univariate RR = 0.48; 95% CI: 0.27, 0.85; P = .012). RF treatment was confirmed as an independent prognostic factor for local recurrence-free survival rates with multivariate analysis (adjusted RR = 0.20; 95% CI: 0.05, 0.73; P = .015). CONCLUSION: RF ablation is superior to PEI with respect to local recurrence-free survival rates.

Original languageEnglish (US)
Pages (from-to)235-240
Number of pages6
JournalRadiology
Volume228
Issue number1
DOIs
StatePublished - Jul 1 2003

Keywords

  • Alcohol ablation
  • Liver neoplasms
  • Liver, cirrhosis
  • Liver, interventional procedures
  • Radiofrequency (RF) ablation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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