RFA/TACE vs TACE Alone: Which Is Better for Early HCC?

Patients treated with percutaneous radiofrequency ablation (RFA) combined with transarterial chemoembolization (RFA/TACE) had better outcomes for single hypervascular hepatocellular carcinoma (HCC) than those treated only with RFA. Researchers reported their findings in Oncology Letters.

The researchers noted that “there is debate regarding the effectiveness of RFA combined with TACE (RFA/TACE) compared with RFA alone.” They undertook their study to better investigate whether RFA alone or the combination treatment (RFA/TACE) led to better outcomes for patients with early HCC.

Eight-three HCC tumors (all single hypervascular tumors) in 83 patients treated with RFA were analyzed as part of the study, which took place at 3 centers. Treatment occurred between April 2007 and August 2014. The median diameter of the tumors was 16 mm.

Results showed that RFA/TACE significantly improved overall survival compared with RFA alone. In addition, intrahepatic distant recurrence and tumor-free survival (TFS) also showed significant improvement with RFA/TACE.

Researchers performed a univariate analysis of prognostic indicators, and this showed that age less than 70 years, aspartate transaminase <40 IU/l, alanine aminotransferase <40 IU/l, and platelet count >10 × 104/µl were linked with a high survival rate.

Multivariate analysis was also performed, and it showed that RFA/TACE is an independent prognostic indicator. In addition, RFA/TACE was found to be the only independent indicator of intrahepatic distant recurrence and TFS. Overall survival rate, intrahepatic distant recurrence, and TFS were also better in patients treated with RFA/TACE compared with those treated with RFA alone.

“In conclusion, the present study revealed that treatment with RFA/TACE improved prognosis, the rate of intrahepatic recurrence and tumor-free survival compared with RFA alone. The present study therefore demonstrated that RFA/TACE is effective in patients with small HCC,” the researchers concluded. They added that “a large-scale randomized controlled trial is  required to compare the results with those obtained from therapy using RFA alone.”

References

Tamai T, Oshige A, Tabu K, et al. Utility of percutaneous radiofrequency ablation alone or combined with transarterial chemoembolization for early hepatocellular carcinoma. Oncol Lett. 2017;14(3):3199-3206.