Survival After Radiofrequency Ablation Might be 'Comparable' to Resection for Liver Cancer

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(ChemotherapyAdvisor) – Radiofrequency ablation (RFA) might offer “comparable” survival rates when compared with liver surgery for patients with hepatocellular carcinoma (HCC), researchers report in the International Journal of Surgery.

“Our result showed comparable overall survival between RFA and surgery, although RFA was associated with a significantly higher tumor recurrence rate” and poorer disease-free survival  rates, reported Eric C.H. Lai, MBChB, FRACS, and Chung Ngai Tang, MD, of the Department of Surgery, Pamela Youde Nethersole Eastern Hospital in Hong Kong. “RFA had the advantages over surgical resection [of] being less invasive and having lower morbidity.”

Partial hepatectomy and liver transplantation “offer the best chance of cure in patients with resectable tumor,” the authors emphasized.  RFA is generally considered inappropriate for local HCC tumor control when tumors measure >3 cm. But early reports have suggested that RFA may offer comparable survival rates for patients with smaller HCC tumors (≤3 cm).

The authors conducted a nonrandomized single-institution comparative study of outcomes among 111 consecutive patients with HCC, who received either RFA (n=31) or hepatic resection (n=80).

Complications were less frequent and severe following RFA than after surgical resection (3.2% vs. 25%), the authors found. “Hospital stay was significantly shorter in the RFA group than in the resection group (mean, 3.8 vs 6.8 days),” as well, they reported.

The 3- and 5-year disease-free survival  rates were significantly lower among patients who underwent RFA than those who underwent resection (40% vs 60% in each case), but that was not the case with overall survival  rates. The “1-, 3- and 5-year overall survival rates for the RFA group and the resection group were 100%, 92%, 84%, and 92%, 75%, 71%, respectively,” they reported (P=0.166, n.s.).

“Our study showed that hepatic resection offered better local control of HCC with reduced local recurrence rates and longer disease-free survival compared with RFA, but these advantages did not translate into better overall survival,” the authors concluded. “The explanation for this lies with the high early mortality of resection, death resulting from underlying liver disease and the potential for new foci of HCC to develop elsewhere in the cirrhotic liver remnant. Repeat resection is rarely possible and even RFA can be more difficult to perform in patients after resection.”

Abstract

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