Treatment of small HCC through radiofrequency ablation and laser ablation. Comparison of techniques and long-term results

Purpose. The aim of this trial was to compare the results obtained using laser ablation (LA) and radiofrequency ablation (RFA) to treat small hepatocellular carcinomas (HCC). Materials and methods. From 2003 to 2005, a total of 81 cirrhotic patients (59 Child-Pugh A, 22 Child-Pugh B) presenting a total of 95 HCC nodules (mean diameter 27.9 mm) were treated with LA (41) and RFA (40). Results. Computed tomography (CT) revealed complete tumour ablation in 78% of nodules treated with LA and in 94% of those treated with RA; the disease-free interval was 16.50 +/- 8.1 months. The cumulative survival rates were 91.8%, 59% and 28.4% at 12, 36 and 60 months, respectively. The patients treated with RFA had better survival rates than those treated with LA, although this difference was not statistically significant (p=0.3299). Univariate analysis of survival revealed statistically significant differences between the Child-Pugh A and B groups (p < 0.0001), between HCC nodules measuring <= 25 mm and > 25 mm (p=0.0001) and between patients with a single nodule and with two nodules (p=0.0484). Conclusions. We found LA and RFA to be equally effective. However, RA appears more suited to patients with small HCC nodules and in Child-Pugh class A.