Clinical

Radiofrequency ablation safer but less effective than surgery for early HCC

Last Updated: 2014-01-17 15:59:58 -0500 (Reuters Health)

By Reuters Staff

NEW YORK (Reuters Health) - Radiofrequency ablation may be safer than surgery for early hepatocellular carcinoma (HCC), but with more recurrence and poorer long-term survival, according to a meta-analysis.

In the short-term, however, radiofrequency ablation (RFA) was as effective as hepatic resection, the researchers wrote in a PLOS One report online January 3.

The meta-analysis, led by Dr. Yingqiang Wang of the Chinese Cochrane Center at Sichuan University in Chengdu, China, included data from three randomized controlled trials and 25 nonrandomized trials. A total of 11,873 patients with early HCC as defined by the Milan criteria or the UCSF criteria were included, 6,094 of whom received RFA and 5,779 of whom underwent surgery.

Based on data from the randomized trials only, there was no difference in one- and three-year overall survival by treatment. However, five-year overall survival was significantly worse with RFA vs resection (RR, 0.72).

Recurrence rates at three and five years were also higher with RFA vs resection (RR, 1.48 and 1.52, respectively).

The complication rate with RFA, on the other hand, was significantly lower than with surgery (RR, 0.18).

Data from nonrandomized trials were similar. One-, three-, and five-year overall survival were all worse with RFA, and ablation was also linked with a higher recurrence rate (p<0.05).

The investigators conclude that RFA "is comparable to hepatic resection with lower complication rates but with higher recurrence rates."

They add, "All relevant risk factors that may affect the final outcome of patients should be considered, so as to balance minimizing recurrent HCC after radiofrequency ablation with improving the quality of life of patients."

The authors did not respond to a request for comment.

SOURCE: http://bit.ly/1cjzHaS

PLoS One 2014.