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Comparison of Radiofrequency Ablation and Transarterial Chemoembolization for Hepatocellular Carcinoma in the Caudate Lobe

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Abstract

Background and Aims

Hepatocellular carcinoma (HCC) in the caudate lobe is technically challenging for both radiofrequency ablation (RFA) and transarterial chemoembolization (TACE). However, each of these modalities has its strengths. This retrospective study compares the effectiveness of RFA and TACE in patients with caudate HCC within the Milan criteria.

Methods

This study was approved by institutional review board. Between November 2005 and August 2016, we retrospectively reviewed 74 patients with a single HCC ≤ 5 cm or up to three HCCs ≤ 3 cm without vascular invasion or extrahepatic metastasis who were treated with RFA (n = 43) or TACE (n = 31). The overall survival (OS) and local progression rates were compared after propensity score analysis.

Results

The mean follow-up period was 2.8 ± 1.9 years. The 1-, 2-, and 3-year survival rates were 97.1, 94.0, and 80.7% for the RFA group and 89.0, 80.8, and 62.0% for the TACE group, respectively. The clinical variables of the RFA and the TACE groups were well balanced by propensity score adjustment, and the RFA group showed better OS (P = .039) and local progression rates (P = .004) than the TACE group.

Conclusions

RFA appears to outperform TACE for patients with caudate HCC within the Milan criteria and should be the favored treatment option when surgical resection is not feasible.

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Author notes

  1. Po-Huang Lee and Po-Chin Liang have contributed equally to this work.

Authors and Affiliations

  1. Department of Medical Imaging, National Taiwan University Hospital, No. 7 Chung Shan S. Rd., Taipei City, 10002, Taiwan

    Bo-Ching Lee, Kao-Lang Liu, Chih-Horng Wu & Po-Chin Liang

  2. Department of Surgery, National Taiwan University Hospital and National Taiwan University, College of Medicine, No. 7 Chung Shan S. Rd., Taipei City, 10002, Taiwan

    Kai-Wen Huang, Cheng-Maw Ho, Rey-Heng Hu, Ming-Chih Ho, Yao-Ming Wu & Po-Huang Lee

  3. Department of Surgery, E-Da Hospital, No.1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, 824, Taiwan

    Po-Huang Lee

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  1. Bo-Ching Lee
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Correspondence to Po-Huang Lee or Po-Chin Liang.

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The authors declare that they have no conflict of interest.

Ethical Approval

This retrospective study was performed in accordance with the Declaration of Helsinki and was approved by the ethics committee of our institution.

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Lee, BC., Liu, KL., Wu, CH. et al. Comparison of Radiofrequency Ablation and Transarterial Chemoembolization for Hepatocellular Carcinoma in the Caudate Lobe. Cardiovasc Intervent Radiol 41, 1699–1707 (2018). https://doi.org/10.1007/s00270-018-1978-0

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  • DOI: https://doi.org/10.1007/s00270-018-1978-0

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