Sae-Jin Park1, Eun Ju Cho2, Jeong-Hoon Lee2, Su Jong Yu2, Yoon Jun Kim2, Jung-Hwan Yoon2, Hyo-Jin Kang1, Jeong Hee Yoon1,3, Dong Ho Lee1,3, Se Hyung Kim1,3,4, Jae Young Lee1,3, Jeong Min Lee1,3,4. 1. Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea. 2. Department of Internal Medicine and Liver Research Institute, College of Medicine, Seoul National University, Seoul, Republic of Korea. 3. Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea. 4. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
Abstract
INTRODUCTION: A switching monopolar no-touch radiofrequency ablation (RFA) technique is used for small hepatocellular carcinoma (HCC); however, there have not been any randomized clinical trials comparing this technique to the conventional RFA technique. OBJECTIVE: This study aims to compare the results of two RFA techniques, and to comparatively identify more effective methods to reduce the progression of local tumors associated with small HCC (≤2.5 cm). METHODS: This prospective randomized clinical trial (NCT03375281) recruited a total of 116 participants (M:F, 93:23; 68.3 ± 8.4 years) between October 2016 and September 2017. The primary outcome was the cumulative incidence of local tumor progression (LTP) after RFA. Secondary outcomes included technical success rate, technique efficacy, and RFA procedure characteristics. Kaplan-Meier analysis and the Cox proportional hazard regression model were used. RESULTS: The mean follow-up period was 24.1 months. A sufficient ablative margin was more frequently achieved in the no-touch RFA group (57/60 = 95%) than in the conventional RFA group (50/64 = 78.1%) on immediate follow-up CT (p = 0.01). The cumulative incidence of LTP in the no-touch RFA group was significantly lower than that in the conventional RFA group (p = 0.02). In multivariable analysis, no-touch RFA was the only predictive factor for LTP (p = 0.04, hazard ratio = 0.2, 95% confidence interval = 0.04-0.94). CONCLUSIONS: A switching monopolar no-touch RFA technique is a favorable treatment option and provides lower LTP after RFA compared with conventional RFA for small HCC.
INTRODUCTION: A switching monopolar no-touch radiofrequency ablation (RFA) technique is used for small hepatocellular carcinoma (HCC); however, there have not been any randomized clinical trials comparing this technique to the conventional RFA technique. OBJECTIVE: This study aims to compare the results of two RFA techniques, and to comparatively identify more effective methods to reduce the progression of local tumors associated with small HCC (≤2.5 cm). METHODS: This prospective randomized clinical trial (NCT03375281) recruited a total of 116 participants (M:F, 93:23; 68.3 ± 8.4 years) between October 2016 and September 2017. The primary outcome was the cumulative incidence of local tumor progression (LTP) after RFA. Secondary outcomes included technical success rate, technique efficacy, and RFA procedure characteristics. Kaplan-Meier analysis and the Cox proportional hazard regression model were used. RESULTS: The mean follow-up period was 24.1 months. A sufficient ablative margin was more frequently achieved in the no-touch RFA group (57/60 = 95%) than in the conventional RFA group (50/64 = 78.1%) on immediate follow-up CT (p = 0.01). The cumulative incidence of LTP in the no-touch RFA group was significantly lower than that in the conventional RFA group (p = 0.02). In multivariable analysis, no-touch RFA was the only predictive factor for LTP (p = 0.04, hazard ratio = 0.2, 95% confidence interval = 0.04-0.94). CONCLUSIONS: A switching monopolar no-touch RFA technique is a favorable treatment option and provides lower LTP after RFA compared with conventional RFA for small HCC.
Authors: Xiaodong Wang; Constantinos T Sofocleous; Joseph P Erinjeri; Elena N Petre; Mithat Gonen; Kinh G Do; Karen T Brown; Anne M Covey; Lynn A Brody; William Alago; Raymond H Thornton; Nancy E Kemeny; Stephen B Solomon Journal: Cardiovasc Intervent Radiol Date: 2012-04-26 Impact factor: 2.740
Authors: Tito Livraghi; Luigi Solbiati; M Franca Meloni; G Scott Gazelle; Elkan F Halpern; S Nahum Goldberg Journal: Radiology Date: 2003-02 Impact factor: 11.105
Authors: Tae Won Choi; Jeong Min Lee; Dong Ho Lee; Jeong-Hoon Lee; Su Jong Yu; Yoon Jun Kim; Jung-Hwan Yoon; Joon Koo Han Journal: Korean J Radiol Date: 2017-07-17 Impact factor: 3.500