• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home The Classics Hematology/Oncology Classics

Radiofrequency thermal ablation superior to percutaneous ethanol injection in hepatocellular carcinoma [Classics Series]

byDeepti Shroff Karhade
June 30, 2022
in Hematology/Oncology Classics, The Classics
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

This study summary is an excerpt from the book 2 Minute Medicine’s The Classics in Medicine: Summaries of the Landmark Trials

1. In patients with hepatocellular carcinoma (HCC) not eligible for surgical resection, the use of radiofrequency thermal ablation (RFA) demonstrated significantly higher local recurrence-free survival compared to percutaneous ethanol injection (PEI).

Original Date of Publication: July 2003

Study Rundown: HCC is the second-leading cause of cancer mortality worldwide and often occurs in the setting of cirrhosis and chronic liver disease. Curative treatment can be obtained with surgical resection or liver transplantation; however, a large proportion of patients are poor candidates for curative treatment due to poor underlying liver function. Both PEI and RFA are alternative modalities that induce local tumor necrosis in patients with HCC with underlying cirrhosis who are not eligible for surgical intervention. The purpose of this randomized controlled trial was to compare the effectiveness of PEI and RFA in patients with HCC. The trial randomized over 100 patients with HCC ineligible for surgical resection or liver transplantation to either RFA or PEI, both performed with ultrasound guidance. Patients were excluded if they had advanced liver disease (Child Pugh class C) or evidence of extra-hepatic disease or vascular invasion. At the conclusion of the trial, there was a significantly higher rate of local recurrence-free survival at 1- and 2 years in the RFA group compared to PEI. Additionally, there was a trend towards the RFA group for improved overall survival, which did not reach statistical significance. The mean number of treatment sessions was significantly lower in the RFA group with no significant increase in the complication rate compared to PEI. The results of this study demonstrate a superiority of RFA compared to PEI and support the use of RFA as the optimal alternative modality in HCC patients ineligible for curative surgical intervention. However, this study does not provide data for survival beyond two-year follow-up; as such, the long-term benefit of RFA over PEI is unknown.

Click to read the study in Radiology

In-Depth [randomized controlled trial]: This was an open-labeled, multi-center randomized controlled trial analyzing the effectiveness of RFA to PEI in patients with HCC not eligible for curative surgical interventions. The inclusion criteria included all adult patients with cirrhosis and a concurrent single HCC < 5 cm in diameter or as many as 3 HCCs with a maximum dimension of < 3 cm in diameter. Patients must be ineligible for surgical intervention or liver transplantation. Key exclusion criteria included presence of extrahepatic disease or evidence of tumor vascular invasion. Patients were also excluded if the HCCs were located less than 1 cm away from the hepatic hilum or gallbladder. The primary outcome was overall survival with a secondary endpoint of local recurrence-free survival rate. Each RFA or PEI procedure was standardized and supervised by a trial co-investigator. Follow-up for evaluation of local recurrence was done by serum α1-fetoprotein and abdominal ultrasound at three-month intervals and dual phase spiral computed tomography at 6 month intervals. Overall, 50 patients were randomized to the PEI group and 52 patients were randomized to the RFA group.  There were no statistically significant differences in baseline characteristics in each treatment group, with the exception of patient age and albumin concentration. Patients were followed up for mean period of 22.9 months and 22.4 months for the RFA and PEI group, respectively. At the conclusion of the trial, the 1- and 2 year local recurrence survival rate was significantly higher in the RFA group compared to the PEI group (RR: 0.17; 95%CI 0.06-0.51; p = 0.002). There was a trend towards increased 1- and 2 year overall survival in the RFA group compared to PEI, which did not reach statistical significance (RR: 0.20; 95%CI 0.02-1.69; p = 0.138). Patients in the PEI group had an average of 5.4 (+/- 1.6) PEI sessions while the RFA group had an average of 1.1 (+/- 0.5) sessions. There was no significant difference in the frequency of adverse events such as post-procedural pain and fever. There were no procedure-related deaths, hemorrhage, or infection noted in either treatment group.

Lencioni RA, Allgaier H-P, Cioni D, Olschewski M, Deibert P, Crocetti L, et al. Small Hepatocellular Carcinoma in Cirrhosis: Randomized Comparison of Radio-frequency Thermal Ablation versus Percutaneous Ethanol Injection. Radiology. 2003 Jul 1;228(1):235–40.

RELATED REPORTS

Plant-based diets may be associated with lower risk of aggressive prostate cancer

Spiritual care reduces fatigue and pain among patients receiving chemotherapy

Religious-based interventions improve illness perception in breast cancer patients

©2022 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: cancerChild-Pughhepatocellular carcinomaoverall survivalsurgical resection
Previous Post

Lisocabtagene maraleucel improves survival for relapsed or refractory large B-cell lymphoma

Next Post

Intraperitoneal chemotherapy improves advanced ovarian cancer survival [Classics Series]

RelatedReports

Vegetarian diet may lower incidence of colorectal cancer
Lifestyle

Plant-based diets may be associated with lower risk of aggressive prostate cancer

January 27, 2023
No benefit of erlotinib in combined hepatocellular carcinoma treatment
Oncology

Spiritual care reduces fatigue and pain among patients receiving chemotherapy

January 11, 2023
Palliative care consultation linked to lower deaths by failed code resuscitation
Oncology

Religious-based interventions improve illness perception in breast cancer patients

January 9, 2023
#VisualAbstract: Positive prostate MRI and targeted biopsy reduce the detection of clinically insignificant prostate cancer
StudyGraphics

#VisualAbstract: Positive prostate MRI and targeted biopsy reduce the detection of clinically insignificant prostate cancer

January 4, 2023
Next Post
The ABCD2 score: Risk of stroke after Transient Ischemic Attack (TIA) [Classics Series]

Intraperitoneal chemotherapy improves advanced ovarian cancer survival [Classics Series]

#VisualAbstract: Molnupiravir improves outcomes in non-hospitalized COVID-19 patients

#VisualAbstract: Molnupiravir improves outcomes in non-hospitalized COVID-19 patients

Nearly Half of All Pediatric Buprenorphine Exposures Result in Hospitalization

ACKR1 variant increases risk of azathioprine-related hematopoietic toxicity

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Bisphosphonates, denosumab, abaloparatide, teriparatide, and romosozumab reduce postmenopausal fracture risk
  • Epstein-Barr viral load monitoring reduces risk of post-liver transplant lymphoproliferative disease
  • Homicide deaths are on the rise for children living in the United States
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options