Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Comparison of Combined Therapy Using Conventional Chemoembolization and Radiofrequency Ablation Versus Conventional Chemoembolization for Ultrasound-Invisible Early-Stage Hepatocellular Carcinoma (Barcelona Clinic Liver Cancer Stage 0 or A)

  • Lee, Hyukjoon (Division of Vascular and Interventional Radiology, Department of Radiology, Seoul National University Bundang Hospital) ;
  • Yoon, Chang Jin (Division of Vascular and Interventional Radiology, Department of Radiology, Seoul National University Bundang Hospital) ;
  • Seong, Nak Jong (Division of Vascular and Interventional Radiology, Department of Radiology, Seoul National University Bundang Hospital) ;
  • Jeong, Sook-Hyang (Division of Internal Medicines, Seoul National University Bundang Hospital) ;
  • Kim, Jin-Wook (Division of Internal Medicines, Seoul National University Bundang Hospital)
  • Received : 2018.02.26
  • Accepted : 2018.05.16
  • Published : 2018.12.01
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Abstract

Objective: To compare the therapeutic efficacy between conventional transarterial chemoembolization (cTACE) and combined therapy using cTACE and radiofrequency ablation (RFA) in ultrasound (US)-invisible early stage hepatocellular carcinoma (HCC). Materials and Methods: From January 2008 to June 2016, 167 patients with US-invisible early stage HCCs were treated with cTACE alone (cTACE group; n = 85) or cTACE followed by immediate fluoroscopy-guided RFA targeting intratumoral iodized oil retention (combined group; n = 82). Procedure-related complications, local tumor progression (LTP), time to progression (TTP), and overall survival (OS) were compared between the two groups. Multivariate analyses were performed to identify prognostic factors. Results: There was no major complication in either group. The cTACE group showed higher 1-, 3-, and 5-year LTP rates than the combined group; i.e., 12.5%, 31.7%, and 37.0%, respectively, in the cTACE group; compared to 7.3%, 16.5%, and 16.5%, respectively, in the combined group; p = 0.013. The median TTP was 18 months in the cTACE group and 24 months in the combined group (p = 0.037). Cumulative 1-, 3-, and 5-year OS rates were 100%, 93.2%, and 87.7%, respectively, in the cTACE group and 100%, 96.6%, and 87.4%, respectively, in the combined group (p = 0.686). Tumor diameter > 20 mm and cTACE monotherapy were independent risk factors for LTP and TTP. Conclusion: Combined therapy using cTACE followed by fluoroscopy-guided RFA is a safe and effective treatment in US-invisible early stage HCCs. It provides less LTP and longer TTP than cTACE alone.

Keywords

Acknowledgement

Supported by : SNUBH

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