Hepatocellular carcinoma (HCC) is the fifth leading cause of cancer worldwide, and its incidence is constantly increasing.1,2 There are 13,000?19,000 cases per year in the US and 350,000 to one million cases per year worldwide.3?5 Chronic hepatitis C (HCV) infection and improved survival of patients with cirrhosis seem to account for most of this rising incidence.

Recent studies have suggested that combining ?Radiofrequency Ablation? with ?Chemoembolisation? is an extremely effective approach in management of early stage of hepatocellular carcinoma. RFA uses heat energy in the form of localised radiofrequency to coagulate and ablate tumour while in chemoembolisation, chemotherapeutic agents, with or without lipiodol and embolic agents, are injected into the branch of the hepatic artery that feeds the tumor, sparing the surrounding liver parenchyma.

A retrospective study was conducted in Japan to evaluate the long term results of ?radiofrequency ablation with chemoembolisation? with ?hepatectomy? in early stage HCC. They included patients with three or fewer tumours with a maximum diameter of 3 cm or less each or a single tumor with a maximum diameter of 5 cm or less. One hundred four patients underwent combination therapy, and 62 patients underwent hepatectomy.

The 1-, 3-, and 5-year overall survival rates following combination therapy (98%, 94%, and 75%, respectively) were similar (P = .87) to those following hepatectomy (97%, 93%, and 81%, respectively). The 1-, 3-, and 5-year recurrence-free survival rates were also comparable (P = .70) for combination therapy (92%, 64%, and 27%, respectively) and hepatectomy (89%, 69%, and 26%, respectively).

Publisher: Dr Nitha Thejal

Source:
Author: Dr Nitha Thejal
Date: Thursday, November 06, 2008

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