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Cited by 592Hepatocellular Carcinoma Treatment and PrognosisRenal cell carcinoma treatmentUltrasound and Hyperthermia Applications

Randomised controlled trial comparing percutaneous radiofrequency thermal ablation, percutaneous ethanol injection, and percutaneous acetic acid injection to treat hepatocellular carcinoma of 3 cm or less

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Lin, S-M, Lin, C-J, Lin, C-C, Hsu, C-W, Chen, Y-C·2005·Gut
DOI 10.1136/gut.2004.045203PMC PMC1774888
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Abstract

Aims: The aim of this study was to compare the outcomes of radiofrequency thermal ablation (RFTA), percutaneous ethanol injection (PEI), and percutaneous acetic acid injection (PAI) in the treatment of hepatocellular carcinoma (HCC). Patients and methods: A total of 187 patients with HCCs of 3 cm or less were randomly assigned to RFTA (n = 62), PEI (n = 62), or PAI (n = 63). Tumour recurrence and survival rates were assessed. Results: One, two, and three year local recurrence rates were 10%, 14%, and 14% in the RFTA group, 16%, 34%, and 34% in the PEI group, and 14%, 31%, and 31% in the PAI group (RFTA v PEI, p = 0.012; RFTA v PAI, p = 0.017). One, two, and three year survival rates were 93%, 81%, and 74% in the RFTA group, 88%, 66%, and 51% in the PEI group, and 90%, 67%, and 53% in the PAI group (RFTA v PEI, p = 0.031; RFTA v PAI, p = 0.038). One, two, and three year cancer free survival rates were 74%, 60%, and 43% in the RFTA group, 70%, 41%, and 21% in the PEI group, and 71%, 43%, and 23% in the PAI group (RFTA v PEI, p = 0.038; RFTA v PAI, p = 0.041). Tumour size, tumour differentiation, and treatment methods (RFTA v PEI and PAI) were significant factors for local recurrence, overall survival, and cancer free survival. Major complications occurred in 4.8% of patients (two with haemothorax, one gastric perforation) in the RFTA group and in none in two other groups (RFTA v PEI and PAI, p = 0.035). Conclusions: RFTA was superior to PEI and PAI with respect to local recurrence, overall survival, and cancer free survival rates, but RFTA also caused more major complications.

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  • Radiofrequency ablation or microwave ablation provides better overall survival and objective response rates with fewer sessions than percutaneous ethanol injection.

    “Percutaneous ethanol injection was the original ablation technique, although this has been largely replaced by radiofrequency ablation (RFA) or microwave ablation (MWA), which provide both superior OS and objective response rates (ORRs) with fewer sessions41.”

    From Adjuvant and neoadjuvant immunotherapies in hepatocellular carcinoma (2024) · cites this paper as [41]

    The Discussion (page unavailable) reports higher overall survival with radiofrequency thermal ablation (RFTA) than with percutaneous ethanol injection (PEI) for hepatocellular carcinomas of 3 cm or less. The Complete tumour necrosis section (page unavailable) reports a higher necrosis rate and fewer treatment sessions with RFTA, but does not label the necrosis measure an objective response rate. The paper does not study microwave ablation or establish that either technique has largely replaced PEI. (LLM, conf=0.88)

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Authors
Lin, S.-M., Lin, C.-J., Lin, C.-C., Hsu, C.-W., & Chen, Y.-C.
Affiliations
Chang Gung University (TW)
Corresponding author
Lin, S-M
Venue
Gut
Publisher
BMJ
Published
2005-07-11
Volume
54
Issue
8
Pages
1151-1156
ISSN
  • 0017-5749 (ISSN-L)
  • 1468-3288
DOI
10.1136/gut.2004.045203
PMC
PMC1774888
OpenAlex
W2096376421
Cited by
592
References
94
Citations by year
2026: 3 · 2025: 6 · 2024: 13 · 2023: 18 · 2022: 17 · 2021: 24 · 2020: 16 · 2019: 20 · 2018: 23 · 2017: 23 · 2016: 32 · 2015: 42 · 2014: 44 · 2013: 42 · 2012: 41
FWCI
19.42
Type
journal article
Language
en
Open access
Locations
  • Gut (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
Medical Research Council
Topics
  • Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal cell carcinoma treatment
  • Physical Sciences › Engineering › Biomedical Engineering › Ultrasound and Hyperthermia Applications
Keywords
hepatocellular carcinoma, radiofrequency ablation, percutaneous ethanol injection, local recurrence, overall survival, tumor-free survival, small tumors, treatment complications, hemothorax, gastric perforation, liver resection alternatives, liver transplantation alternatives
MeSH terms
Ethanol, Antineoplastic Agents, Female, Carcinoma, Hepatocellular, Humans, Liver Neoplasms, Male, Middle Aged, Necrosis, Neoplasm Recurrence, Local, Injections, Intralesional, Survival Rate, Treatment Outcome, Catheter Ablation, Acetic Acid

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