Combined percutaneous radiofrequency ablation and ethanol injection versus hepatic resection for 2.1–5.0 cm solitary hepatocellular carcinoma: a retrospective comparative multicentre study
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To compare combined percutaneous radiofrequency ablation and ethanol injection (RFA-PEI) with hepatic resection (HR) in the treatment of resectable solitary hepatocellular carcinoma (HCC) with 2.1–5.0 cm diameter.
From June 2009 to December 2015, 271 patients whom underwent RFA-PEI (n = 141) or HR (n = 130) in three centres were enrolled. The overall survival (OS) and recurrence-free survival (RFS) between groups were compared with Kaplan–Meier method and log-rank tests. Complications, hospital stay and cost were assessed.
The OS rates at 1, 3 and 5 years were 93.5%, 72.7%, 58.6% in RFA-PEI group and 82.3%, 57.5%, 51.8% in HR group (p = 0.021). The corresponding 1-, 3- and 5-year RFS rates were 65.8%, 41.3%, 34.3% in RFA-PEI group and 50.5%, 33.8%, 28.4% in HR group (p = 0.038). For patients with 2.1–3.0 cm tumours, the 1-, 3- and 5-year OS after RFA-PEI and HR were 98.0%, 82.3%, 74.2% and 89.4%, 65.1%, 61.9%, respectively (p = 0.024). The corresponding RFS were 79.6%, 54.7%, 45.1% in RFA-PEI group, and 57.6%, 43.9%, 31.7% in HR group, respectively (p = 0.020). RFA-PEI was superior to HR in major complication rates, length of hospital stay and cost (all p < 0.001).
RFA-PEI had a survival benefit over HR in the treatment of solitary HCCs, especially for those with 2.1–3.0 cm in diameter.
• RFA-PEI provided superior survival to HR in solitary HCC with 2.1–5.0 cm in diameter.
• RFA-PEI is superior to HR in complications, length of hospital stay and cost.
• RFA-PEI might be an alternative treatment for solitary HCC within 5.0 cm in diameter.
KeywordsAblation techniques Ethanol Hepatectomy Carcinoma, hepatocellular Comparative study
Barcelona clinic liver cancer
Contrast-enhanced computed tomography
Eastern cooperative oncology group
Local tumour progression
Percutaneous ethanol injection
Randomized controlled trial
This study has received funding by the National Natural Science Foundation of China (No. 81272312; No. 81301842), Pearl River S&T Nova Program of Guangzhou, China (No. 2014J2200087) and Guangdong Medical Science and Technology Foundation (No. 20161192364982).
Compliance with ethical standards
The scientific guarantor of this publication is Ming Kuang.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Statistics and biometry
One of the authors (Bin Li) has significant statistical expertise.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional review board approval was obtained.
• multicentre study
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