Radiofrequency ablation and chemoembolization for hepatocellular carcinoma

Area of Science:

• Hepatobiliary Oncology
• Interventional Radiology
• Medical Oncology

Background:

• Hepatocellular carcinoma (HCC) is a primary liver cancer with limited treatment options.
• Radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) are established locoregional therapies for HCC.
• Understanding the evolving role and efficacy of RFA and TACE is crucial for optimal patient management.

Purpose of the Study:

• To review the current techniques, efficacy, safety, and clinical applications of RFA and TACE for HCC.
• To synthesize findings from existing literature and extensive clinical experience.
• To provide an up-to-date overview of these interventional therapies for HCC.

Main Methods:

• Comprehensive literature review focusing on RFA and TACE in HCC treatment.
• Integration of published data with clinical experience from over 1000 patients treated with both modalities.
• Analysis of survival data and treatment response rates from relevant studies.

Main Results:

• Transarterial chemoembolization (TACE) demonstrates significant survival benefits for unresectable HCC, with 1-, 2-, and 3-year survival rates of 57%, 31%, and 26% respectively in treated groups.
• Radiofrequency ablation (RFA) shows high efficacy for small HCC lesions (≤3 cm), achieving a ~90% complete response rate and potentially matching surgical resection outcomes.
• Both RFA and TACE require careful patient selection and technique to minimize rare complications like liver failure, abscess, and hemorrhage.

Conclusions:

• RFA and TACE provide survival advantages for patients with unresectable HCC.
• Combination therapies involving RFA/TACE with surgical resection, systemic treatments, or for liver transplantation candidates are yielding favorable outcomes.
• Advancements in RFA/TACE techniques, technology, and chemotherapy are expected to further improve HCC patient survival and broaden treatment applicability.