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Combined percutaneous radiofrequency ablation and ethanol injection versus hepatic resection for 2.1–5.0 cm solitary hepatocellular carcinoma: a retrospective comparative multicentre study

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Abstract

Objectives

To compare combined percutaneous radiofrequency ablation and ethanol injection (RFA-PEI) with hepatic resection (HR) in the treatment of resectable solitary hepatocellular carcinoma (HCC) with 2.1–5.0 cm diameter.

Methods

From June 2009 to December 2015, 271 patients whom underwent RFA-PEI (n = 141) or HR (n = 130) in three centres were enrolled. The overall survival (OS) and recurrence-free survival (RFS) between groups were compared with Kaplan–Meier method and log-rank tests. Complications, hospital stay and cost were assessed.

Results

The OS rates at 1, 3 and 5 years were 93.5%, 72.7%, 58.6% in RFA-PEI group and 82.3%, 57.5%, 51.8% in HR group (p = 0.021). The corresponding 1-, 3- and 5-year RFS rates were 65.8%, 41.3%, 34.3% in RFA-PEI group and 50.5%, 33.8%, 28.4% in HR group (p = 0.038). For patients with 2.1–3.0 cm tumours, the 1-, 3- and 5-year OS after RFA-PEI and HR were 98.0%, 82.3%, 74.2% and 89.4%, 65.1%, 61.9%, respectively (p = 0.024). The corresponding RFS were 79.6%, 54.7%, 45.1% in RFA-PEI group, and 57.6%, 43.9%, 31.7% in HR group, respectively (p = 0.020). RFA-PEI was superior to HR in major complication rates, length of hospital stay and cost (all p < 0.001).

Conclusion

RFA-PEI had a survival benefit over HR in the treatment of solitary HCCs, especially for those with 2.1–3.0 cm in diameter.

Key Points

• RFA-PEI provided superior survival to HR in solitary HCC with 2.1–5.0 cm in diameter.

• RFA-PEI is superior to HR in complications, length of hospital stay and cost.

• RFA-PEI might be an alternative treatment for solitary HCC within 5.0 cm in diameter.

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Abbreviations

BCLC:

Barcelona clinic liver cancer

CECT:

Contrast-enhanced computed tomography

CEUS:

Contrast-enhanced ultrasound

ECOG:

Eastern cooperative oncology group

HCC:

Hepatocellular carcinoma

HR:

Hepatic resection

LTP:

Local tumour progression

MWA:

Microwave ablation

OS:

Overall survival

PEI:

Percutaneous ethanol injection

RCT:

Randomized controlled trial

RFA:

Radiofrequency ablation

RFS:

Recurrence-free survival

TACE:

Transarterial chemoembolization

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Funding

This study has received funding by the National Natural Science Foundation of China (No. 81272312; No. 81301842), Pearl River S&T Nova Program of Guangzhou, China (No. 2014J2200087) and Guangdong Medical Science and Technology Foundation (No. 20161192364982).

Author information

Author notes

  1. Shuling Chen and Zhenwei Peng contributed equally to this work.

Authors and Affiliations

  1. Division of Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhong Shan Road 2, Guangzhou, 510080, China

    Shuling Chen, Manxia Lin, Xiaoyan Xie & Ming Kuang

  2. Department of Oncology, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhong Shan Road 2, Guangzhou, 510080, China

    Zhenwei Peng

  3. Clinical Trial Unit, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhong Shan Road 2, Guangzhou, 510080, China

    Zhenwei Peng & Bin Li

  4. Department of Liver Surgery, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhong Shan Road 2, Guangzhou, 510080, China

    Zebin Chen, Wenjie Hu, Baogang Peng & Ming Kuang

  5. Department of Ultrasound, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China

    LongZhong Liu

  6. Department of Minimal Invasion Therapy, The Affiliated Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, 200438, China

    Guojun Qian

Authors
  1. Shuling Chen
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  2. Zhenwei Peng
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  3. Manxia Lin
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  4. Zebin Chen
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  7. LongZhong Liu
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  8. Guojun Qian
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  9. Baogang Peng
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  10. Bin Li
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  11. Ming Kuang
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Corresponding author

Correspondence to Ming Kuang.

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Guarantor

The scientific guarantor of this publication is Ming Kuang.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (Bin Li) has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional review board approval was obtained.

Methodology

• retrospective

• observational

• multicentre study

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Chen, S., Peng, Z., Lin, M. et al. Combined percutaneous radiofrequency ablation and ethanol injection versus hepatic resection for 2.1–5.0 cm solitary hepatocellular carcinoma: a retrospective comparative multicentre study. Eur Radiol 28, 3651–3660 (2018). https://doi.org/10.1007/s00330-018-5371-9

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  • DOI: https://doi.org/10.1007/s00330-018-5371-9

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