Efficacy and Safety of Combined Radiofrequency Ablation with Transarterial Chemoembolization in Patients with Barcelona Clinic Liver Cancer Stage A Hepatocellular Carcinoma Ineligible for Curative Treatment
10.4166/kjg.2019.73.3.167
- Author:
Ah Ran KIM
1
;
Eugene PARK
;
So Young KWON
;
Seong Jun PARK
;
Young Jung KIM
;
Byung Chul YOO
;
Won Hyeok CHOE
;
Jeong Han KIM
;
Jin Ho HWANG
;
Sang Woo PARK
;
Young Jun KIM
;
Hee Sun PARK
;
Mi hye YU
;
Hae jeong JEON
Author Information
1. Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea. sykwonmd@hotmail.com
- Publication Type:Original Article
- Keywords:
Hepatocellular carcinoma;
Transarterial chemoembolization;
Radiofrequency ablation;
Treatment outcome
- MeSH:
Academic Medical Centers;
Carcinoma, Hepatocellular;
Catheter Ablation;
Follow-Up Studies;
Humans;
Liver Neoplasms;
Liver;
Recurrence;
Survival Rate;
Treatment Outcome
- From:The Korean Journal of Gastroenterology
2019;73(3):167-176
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Surgical resection or ablation is recommended for the treatment of early hepatocellular carcinoma (HCC), whereas transarterial chemoembolization (TACE) is frequently used in early HCC ineligible for curative resection. We evaluated the clinical effects and safety of radiofrequency ablation (RFA) shortly after TACE in patients with Barcelona clinic liver cancer (BCLC) stage A HCC. METHODS: Sixty-seven BCLC stage A HCC patients who failed to achieve complete response to TACE as either a first line treatment and who subsequently received RFA at the Konkuk University Medical Center from January 2005 to December 2017 were included. Evaluation indices included treatment response, overall survival rate, recurrence-free survival, prognostic factors, and procedure-related complications. RESULTS: Median follow-up was 46.9 months. Fifty-four (80.6%) patients were of Child-Pugh class A, and 13 (19.4%) were of class B. Modified UICC stages were I in 10 (14.9%), II in 46 (68.7%), and III in 11 (16.4%) patients. In the 67 study subjects, cumulative recurrence-free survival rates were 86.8%, 55.9% and 29.7% at 1, 3, and 5 years, respectively, and overall survival rates were 100%, 93.4%, and 83.5% at 1, 3, and 5 years, respectively. Tumor size significantly predicted recurrence. No treatment-related death occurred. CONCLUSIONS: Combination of RFA was an efficient and safe treatment for BCLC stage A HCC patients that failed to achieve complete response to initial TACE. We suggest TACE plus RFA be considered as a curative option for early HCC patients ineligible for curative resection of RFA.
