Drug & Device Development

Radiofrequency ablation a good option in early HCC, for some

Last Updated: 2011-08-03 16:30:14 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Radiofrequency ablation (RFA) is a viable option for patients with early hepatocellular carcinoma (HCC) who are not candidates for surgery, a Taiwanese study confirms.

RFA is already widely used for HCC patients with limited hepatic reserve, as Dr. Sheng-Nan Lu and colleagues at Chang Gung Memorial Hospital-Kaohsiung Medical Center note in their paper.

Their new study showed that for patients with well preserved liver function and early or very early HCC, five-year survival was equivalent with either approach, but disease-free survival was better with surgery.

The choice of candidates for surgical resection "depended on the judgment of the surgeon and patients' preference," Dr. Lu told Reuters Health by email.

Surgery might have been contraindicated due to an abnormal indocyanine green test, inadequate liver volume after resection, or other medical conditions, he said.

The team reviewed data on 605 patients, including 143 with very early disease and 462 with early disease as staged by the Barcelona Clinic Liver Cancer system, according to a July 12th online paper in the Journal of Hepatology.

At three years, overall survival was 98.0% in patients who had surgery and 80.3% in those who had RFA. Disease-free survival was 62.1% after surgery and 39.8% after RFA.

At five years, overall survival rates in the surgery and RFA groups were 91.5% and 72.0%, respectively. Disease-free survival rates were 40.7% in patients who had surgery vs 29.3% in patients treated with RFA.

After adjustment there was no difference in overall survival, but disease-free survival was greater in the resection group.

So while RFA may be an option for patients ineligible for surgery, the researchers conclude that "In clinical practice, surgical resection should be assessed as the initial treatment modality when liver transplantation is not feasible."

SOURCE: http://bit.ly/r1ROsc

J Hepatol 2011.