Clinical

Radiofrequency ablation better than ethanol injection for small liver cancers

Last Updated: 2005-08-09 12:58:57 -0400 (Reuters Health)

NEW YORK (Reuters Health) - As a treatment for small hepatocellular carcinoma, radiofrequency ablation provides better survival than ethanol injections, with no increase in adverse events, Japanese researchers report.

Ethanol injection is the current standard therapy for hepatocellular carcinoma, whereas percutaneous radiofrequency ablation is a newer, less-established treatment. While there is evidence that radiofrequency ablation may offer better tumor destruction, until now, a comparison of the long-term outcomes of these approaches had not been performed.

As reported in the July issue of Gastroenterology, Dr. Shuichiro Shiina and colleagues, from the University of Tokyo in Japan, assessed the outcomes of 232 patients with up to three small (3 cm or less in diameter) cancerous lesions who were randomized to undergo radiofrequency ablation or ethanol injection. All of the subjects had liver function of Child-Pugh class A or B.

The 4-year survival rates in the radiofrequency ablation and ethanol injection groups were 74% and 57%, respectively. Compared with ethanol injection, radiofrequency ablation provided significantly smaller risks of death, overall recurrence, and local tumor progression.

As noted, the rate of adverse events with each treatment modality was comparable. However, radiofrequency ablation was associated with fewer treatment sessions and with shorter hospital stays than ethanol injection (p < 0.0001 for both).

"Judging from the higher survival but similar adverse events compared with ethanol injection, radiofrequency ablation may be a treatment of choice in patients with small, unresectable hepatocellular carcinoma," the authors conclude.

Gastroenterology 2005;129:122-130.