Liver, Pancreas and Biliary TractRadiofrequency ablation plus drug-eluting beads transcatheter arterial chemoembolization for the treatment of single large hepatocellular carcinoma

BackgroundOur aim was to evaluate the effectiveness of the single-step combined therapy with radiofrequency ablation and drug-eluting beads transarterial chemoembolization in single hepatocellular carcinoma (HCC) larger than 3 cm. Secondary aim was to compare the results with those obtained in a matched population treated with drug-eluting beads transarterial chemoembolization alone.Methods40 consecutive cirrhotic patients with single HCC were prospectively enrolled and treated. Twenty-three patients had tumours between 3 and 5 cm (Group A), and 17 larger than 5 cm (Group B). Twenty cirrhotic patients with single HCC treated only with chemoembolization formed the control group.ResultsComplete response at 1 month was achieved in 32/40 tumours (80%). During follow-up, complete response was maintained in 25 patients (25/40, 62.5%), and this rate was higher in Group A (69.6% vs 53%, p = 0.008). The group treated with combined therapy showed a significantly lower 2-year recurrence (48.1% vs 78.2%, p < 0.001) and significantly higher survival (91.1% vs 60.6%, p = 0.004) than the group treated with chemoembolization alone.ConclusionsBalloon-occluded-radiofrequency ablation plus drug-eluting beads transarterial chemoembolization is an effective treatment of HCC larger than 3 cm not amenable to surgical resection, providing better results than transarterial chemoembolization alone. The best results are achieved in tumours up to 5 cm.