Survival with up to 10-year Follow-up after Combination Therapy of Chemoembolization and Radiofrequency Ablation for the Treatment of Hepatocellular Carcinoma: Single-center Experience

Purpose: To report 10-year outcomes of treating hepatocellular carcinomas (HCCs) by combination therapy of chemoembolization and radiofrequency (RF) ablation. Materials and Methods: Combination therapy was administered in 277 patients with 382 treatment-naive HCCs. Therapeutic effects, safety, survival rate, and prognostic factors were evaluated. Results: Tumor enhancement disappeared after 466 RF sessions in all tumors, resulting in a complete response rate of 100% (277 of 277) based on modified Response Evaluation Criteria In Solid Tumors. Local tumor progression developed in 15 patients (5.4%; 15 of 277) during the mean follow-up of 44.9 months +/- 29.1 (range, 6.0-134.4 mo). Overall and recurrence-free survival rates were 56.3% (95% confidence interval [CI], 52.5%-60.2%) and 22.5% (95% CI, 19.3%-25.6%) at 5 years and 23.5% (95% CI, 17.7%-29.2%) and 9.3% (95% CI, 6.3%-12.4%) at 10 years. The Child-Pugh class was the only significant prognostic factor detected in both the univariate (P < .001) and the multivariate analyses (hazard ratio, 3.8; 95% CI, 2.5-5.6; P < .001) The 5-year and 10-year overall Survival rates were 66.4% (95% CI, 62.0%-70.8%) and 30.6% (95% CI, 23.3%-37.9%) hi. 210 Child-Pugh class A patients. In addition to the Child-Pugh class, the maximum tumor diameter (<= 3 cm vs >3 cm) and the tumor number (single vs multiple) were significant independent factors, affecting recurrence-free survival. No death was related to the combination therapy. The major complication rate was 3.2% (15 of 466). Conclusions: RF ablation combined with chemoembolization is a safe and useful therapeutic option for treating HCCs. Prognostic factors detected in this study help to stratify patients who benefit from this combination. therapy.