Randomised controlled trial comparing percutaneous radiofrequency thermal ablation, percutaneous ethanol iniection, and percutaneous acetic acid iniectuon to treat hepatocellular carcinoma of 3 cm or less

Lin, S.-M.; Lin, C.-J.; Lin, C.-C.; Hsu, C.-W.; Chen, Y.-C.
August 2005
Gut;Aug2005, Vol. 54 Issue 8, p1151
Academic Journal
Aims: The aim of this study was to compare the outcomes of radiofrequency thermal ablation (RFTA), percutaneous ethanol injection (PEI), and percutaneous acetic acid injection (PAI) in the treatment of hepatocellular carcinoma (HCC). Patients and methods: A total of 187 patients with HCCs of 3 cm or less were randomly assigned to RFTA (n = 62), PEI (n = 62), or PAP (n = 63). Tumour recurrence and survival rates were assessed. Results: One, two, and three year local recurrence rates were 10%, 14%, and 14% in the RFTA group, 16%, 34%, and 34% in the PEI group, and 14%, 31%, and 31% in the PAP group (RFTA v PEI, p=0.012; RFTA v PAP, p= 0.017). One, two, and three year survival rates were 93%, 81%, and 74% in the RFTA group, 88%, 66%, and 51% in the PEP group, and 90%, 67%, and 53% in the PAP group (RFTA v PEP, p = 0.031; RFTA v PAI, p = 0.038). One, two, and three year cancer free survival rates were 74%, 60%, and 43% in the RFTA group, 70%, 41%, and 21% in the PEI group, and 71%, 43%, and 23% in the PAI group (RFTA v PEP, p =0.038; RFTA v PAP, p =0.041). Tumour size, tumour differentiation, and treatment methods (RFTA v PEP and PAI) were significant factors for local recurrence, overall survival, and cancer free survival. Major complications occurred in 4.8% of patients (two with haemothorox, one gastric perforation) in the RFTA group and in none in two other groups (RFTA v PEP and PAP, p = 0.035). Conclusions: RFTA was superior to PEI and PAP with respect to local recurrence, overall survival, and cancer free survival rates, but RFTA also caused more major complications.


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