Radiofrequency ablation alone versus radiofrequency ablation combined with chemoembolization in unresectable hepatocellular carcinoma

Objective: To determine the effectiveness of the treatment in unresectable hepatocellular carcinoma between radiofrequency ablation (RFA) alone and combination of RFA and transcatheter arterial chemoembolization (TACE). Material and Method: Forty-six patients with 57 hepatic nodules smaller than 5 cm in maximum diameter were treated with RFA alone in 37 nodules and combined RFA with TACE in 20 nodules. RFA electrode size was varying from 2 to 5 cm diameter. The chemotherapeutic drugs in TACE were mixture of flurouracil with lipiodol and mitomycin-C with lipiodol. The residual tumor, local recurrent, and tumor progression was evaluated by dynamic enhanced CT or MRI study of the liver after treatment. Results: Local response in RFA alone and combined treatment were 97.3% and 70%, respectively. Recurrence rate in RFA alone and combined treatment were 6.9% and 20%, respectively. The average ablative margin visualized on post RFA images were 0.7 cm and 0.4 cm in RFA alone and combined treatment, respectively. Complication rate was 0.07% and all of complications were minor complication. Conclusion: For small unrespectable HCC nodules, RFA ablation alone is the effective treatment, Additional TACE may not be necessary if RFA is performed completely under controlling the important factors, especially ablated margin.