Comparison of Radiofrequency Ablation and Transarterial Chemoembolization for Hepatocellular Carcinoma in the Caudate Lobe

Abstract

Background and Aims: Hepatocellular carcinoma (HCC) in the caudate lobe is technically challenging for both radiofrequency ablation (RFA) and transarterial chemoembolization (TACE). However, each of these modalities has its strengths. This retrospective study compares the effectiveness of RFA and TACE in patients with caudate HCC within the Milan criteria. Methods: This study was approved by institutional review board. Between November 2005 and August 2016, we retrospectively reviewed 74 patients with a single HCC ≤ 5 cm or up to three HCCs ≤ 3 cm without vascular invasion or extrahepatic metastasis who were treated with RFA (n = 43) or TACE (n = 31). The overall survival (OS) and local progression rates were compared after propensity score analysis. Results: The mean follow-up period was 2.8 ± 1.9 years. The 1-, 2-, and 3-year survival rates were 97.1, 94.0, and 80.7% for the RFA group and 89.0, 80.8, and 62.0% for the TACE group, respectively. The clinical variables of the RFA and the TACE groups were well balanced by propensity score adjustment, and the RFA group showed better OS (P =.039) and local progression rates (P =.004) than the TACE group. Conclusions: RFA appears to outperform TACE for patients with caudate HCC within the Milan criteria and should be the favored treatment option when surgical resection is not feasible.