Three-year data show that radiofrequency ablation is as effective as surgical resection for treatment of single small hepatocellular carcinoma tumors in patients with liver cirrhosis, according to a presentation at the annual meeting of the Society of Interventional Radiology.

Surgical resection is considered first-line treatment for patients with small uninodular hepatocellular carcinoma and well-compensated liver cirrhosis.

In the Italian study, 162 patients (38 surgical cases, 124 radiofrequency ablation cases) were evaluated in a matched, case-control study. Overall survival rates were 72 percent at 3 years in the radiofrequency ablation group versus 65 percent at 3 years in the surgical resection group.

The primary endpoint of the study was overall survival. Secondary endpoints were local tumor progression and tumor recurrence. Patients with Child-Pugh class A cirrhosis and uninodular hepatocellular carcinoma not larger than 5 cm who were treated with hepatic resection or radiofrequency ablation were eligible.

Radiofrequency ablation was performed under ultrasound guidance using 150-W generators and expandable electrodes using the RITA Medical device. Matching criteria were date of diagnosis, age at diagnosis, tumor size, and serum alpha-fetoprotein level.

Although the local tumor progression rate in the radiofrequency ablation group was higher than in the surgical group, the incidence of tumor recurrence as well as overall survival was similar. In particular, overall survival rates were 89 percent at 1 year, 78 percent at 2 years, and 65 percent at 3 years in the resection group and 97 percent at 1 year, 84 percent at 2 years, and 72 percent at 3 years in the radiofrequency ablation group.

“Radiofrequency ablation is increasingly accepted as the best treatment option for patients with early-stage hepatocellular carcinoma when surgical resection is precluded,” said interventional radiologist and principal investigator Riccardo Lencioni, MD, Professor of Radiology at the University of Pisa, Italy. “This study is important because it shows that patients who receive radiofrequency ablation can have the same life expectancy as patients in similar condition who undergo surgery.”

He added, “Although historically surgery has offered the only chance for a cure, most patients with liver cancer can not tolerate surgical resection, because of the limited functional reserve of the liver caused by the co-existing cirrhosis. Radiofrequency ablation offers patients a non-surgical option that preserves healthy tissue, is well tolerated and has a short recovery time. It can be repeated as needed to control tumor growth in case of relapse or to treat newly developed tumors.”

According to the American Cancer Society, about 18,500 cases of primary liver cancer are diagnosed each year in the United States, and the most common form is hepatocellular carcinoma.