Retrospective Study
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World J Gastroenterol. Sep 21, 2014; 20(35): 12588-12594
Published online Sep 21, 2014. doi: 10.3748/wjg.v20.i35.12588
Short-term interval combined chemoembolization and radiofrequency ablation for hepatocellular carcinoma
Won Hyeok Choe, Young Jun Kim, Hee Sun Park, Sang Woo Park, Jeong Han Kim, So Young Kwon
Won Hyeok Choe, Jeong Han Kim, So Young Kwon, Department of Internal Medicine, Konkuk University School of Medicine, Seoul 143-729, South Korea
Young Jun Kim, Hee Sun Park, Sang Woo Park, Department of Radiology, Konkuk University School of Medicine, Seoul 143-729, South Korea
Author contributions: Choe WH analyzed the data and wrote the manuscript; Kim YJ designed and performed the study and edited the manuscript in addition to providing financial support for this work; Park HS and Park SW provided analytical tools and were also involved in editing the manuscript; Kim JH and Kwon SY coordinated and collected the data and also supervised the entire research project.
Supported by Konkuk University Medical Center Research Grant 2011
Correspondence to: Young Jun Kim, MD, PhD, Department of Radiology, Konkuk University School of Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 143-729, South Korea. yjkim@kuh.ac.kr
Telephone: +82-2-20305494 Fax: +82-2-20305549
Received: April 2, 2014
Revised: May 10, 2014
Accepted: June 12, 2014
Published online: September 21, 2014
Processing time: 169 Days and 20.1 Hours
Abstract

AIM: To investigate hepatic function after combined transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) with a short-term interval (0-2 d).

METHODS: A total of 115 patients with compensated liver cirrhosis underwent RFA combined with TACE at a time-interval of 0-2 d for the treatment of hepatocellular carcinoma (HCC) < 5.0 cm. There were 21 patients who received further hepatic directed treatment altering liver function within 12 mo after the combined therapy for HCC-recurrence, and were excluded. The remaining 94 patients who survived without HCC-recurrence were included in this retrospective study.

RESULTS: At 1 mo after treatment, Child-Pugh scores (CPs) remained unchanged in 89 of 94 patients (94.7%), and transiently increased by one-point in 5 patients (5.3%). However, the score returned to baseline score at 3 mo and was maintained until 6 mo in all patients. The baseline CPs of 8 or more was identified as a factor for transient rise of CPs after the treatment (CPs 8/9 vs 5/6/7; 21.4% vs 2.5%; P = 0.022). At 12 mo follow-up, CPs was unchanged in 90 patients (95.7%), and increased by one-point in 4 patients (4.3%). The rise of CPs at 12 mo was not statistically associated with the initial transient rise of CPs. There were procedure-related complications in 3 patients (3.2%), but the complications were resolved by medical and interventional treatments without hepatic functional sequelae.

CONCLUSION: The combined TACE and RFA with an interval of 0-2 d are safe for the management of HCC < 5 cm in cirrhotic patients.

Keywords: Child-Pugh score, Liver cirrhosis, Hepatocellular carcinoma, Transcatheter arterial chemoembolization, Radiofrequency ablation

Core tip: This study investigated whether an interval of 0-2 d for combined transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) is acceptable for recovery of liver functional reserve in cirrhotic patients with hepatocellular carcinoma (HCC) < 5 cm. Of 94 enrolled patients, 89 (94.7%) did not show changes in their Child-Pugh scores (CPs) after treatment. Only 5 patients experienced a transient rise of CPs by one-point and their CPs was restored to the baseline within 3 mo after treatment. Therefore, we suggest that the combined TACE and RFA using a short-term interval are safe for treating HCC < 5 cm in cirrhotic patients.