Hepatocellular carcinomas 2-3 cm in diameter: transarterial chemoembolization plus radiofrequency ablation vs. radiofrequency ablation alone.

OBJECTIVE: There is debate whether transarterial chemoembolization (TACE) plus radiofrequency ablation (RFA) is more effective than RFA alone in the treatment of patients with small hepatocellular carcinoma (HCC). We therefore retrospectively compared these treatments in patients with HCCs of diameter 2-3 cm.

MATERIALS AND METHODS: Outcomes, including tumor progression, survival rates, and major complications, were compared in 83 patients (83 tumors) treated with combined TACE and RFA and in 231 patients (231 tumors) treated with RFA alone.

RESULTS: Median follow-up periods were similar in the TACE+RFA and RFA alone groups (37 vs. 38 months). During follow-up, local tumor progression was observed in 16% and 41% of tumors, respectively. The 1, 3, and 5 year local tumor progression-free survival rates were significantly higher in the TACE+RFA group (95%, 86%, and 83%, respectively) than in the RFA-alone group (78%, 61%, and 53%, respectively; P<0.001). The 1, 3, and 5 year overall survival rates, however, were similar in the TACE+RFA (93%, 72%, and 63%, respectively) and RFA (93%, 73%, and 53%, respectively) groups (P=0.545), as were the rates of major complications (1.2% vs. 0.4%).

CONCLUSIONS: Combined TACE and RFA was safe and provided better local tumor control than RFA alone in the treatment of 2- to 3-cm sized HCCs, although survival rates were similar.