Clinical

RF ablation better than injection of ethanol or acetic acid for small liver tumors

Last Updated: 2005-07-26 17:17:04 -0400 (Reuters Health)

NEW YORK (Reuters Health) - For patients with hepatocellular carcinomas measuring 3 centimeters or less, radiofrequency thermal ablation provides a better clinical outcome -- but is associated with more major complications -- than percutaneous injection of ethanol or acetic acid, results of a new study indicate.

Dr. S. M. Lin and colleagues from Chang Gung University in Taipei, Taiwan, assessed tumor recurrence and survival rates among 187 such patients who were randomly assigned to one of these three treatments and followed for a mean of 26.3 months.

Radiofrequency thermal ablation was superior to the other two treatments with respect to lower local recurrence and significantly higher overall and cancer-free survival, the team reports in the August issue of the journal Gut.

Specifically, 1- and 3-year local recurrence rates were 10% and 14% in the radiofrequency ablation arm versus 16% and 34% in the ethanol arm and 14% and 31% in the acetic acid arm.

One- and 3-year overall survival rates were 93% and 74% in the radiofrequency ablation arm versus 88% and 51% in the ethanol arm and 90% and 53% in the acetic acid arm.

One- and 3-year cancer-free survival was 74% and 40% for radiofrequency ablation versus 70% and 21% for ethanol and 71% and 23% for acetic acid.

However, major complications occurred in 4.8% of patients treated with radiofrequency ablation (two hemothorax and one gastric perforation but no deaths) and in none in the other two groups.

This study provides some of the first comparative controlled data on these three treatments for small hepatocellular carcinomas in terms of complications and clinical outcome, the authors note in their report.

Gut 2005;54:1151-1156.