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Korean J Gastroenterol  <  Volume 73(3); 2019 <  Articles

Korean J Gastroenterol 2019; 73(3): 167-176  https://doi.org/10.4166/kjg.2019.73.3.167
Efficacy and Safety of Combined Radiofrequency Ablation with Transarterial Chemoembolization in Patients with Barcelona Clinic Liver Cancer Stage A Hepatocellular Carcinoma Ineligible for Curative Treatment
Ah Ran Kim*, Eugene Park*, So Young Kwon , Seong Jun Park, Young Jung Kim, Byung Chul Yoo, Won Hyeok Choe, Jeong Han Kim,
Jin Ho Hwang1, Sang Woo Park1, Young Jun Kim1, Hee Sun Park1, Mi hye Yu1 and Hae jeong Jeon1
Departments of Internal Medicine and Radiology1, Konkuk University School of Medicine, Seoul, Korea
Correspondence to: So Young Kwon, Department of Internal Medicine, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea. Tel: +82-2-2030-7508, Fax: +82-2-2030-5029, E-mail: sykwonmd@hotmail.com, ORCID: https://orcid.org/0000-0003-4290-1950
Received: November 5, 2018; Revised: December 21, 2018; Accepted: January 17, 2019; Published online: March 25, 2019.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background/Aims: Surgical resection or ablation is recommended for the treatment of early hepatocellular carcinoma (HCC), whereas transarterial chemoembolization (TACE) is frequently used in early HCC ineligible for curative resection. We evaluated the clinical effects and safety of radiofrequency ablation (RFA) shortly after TACE in patients with Barcelona clinic liver cancer (BCLC) stage A HCC.
Methods: Sixty-seven BCLC stage A HCC patients who failed to achieve complete response to TACE as either a first line treatment and who subsequently received RFA at the Konkuk University Medical Center from January 2005 to December 2017 were included. Evaluation indices included treatment response, overall survival rate, recurrence-free survival, prognostic factors, and procedure-related complications.
Results: Median follow-up was 46.9 months. Fifty-four (80.6%) patients were of Child-Pugh class A, and 13 (19.4%) were of class B. Modified UICC stages were I in 10 (14.9%), II in 46 (68.7%), and III in 11 (16.4%) patients. In the 67 study subjects, cumulative recurrence-free survival rates were 86.8%, 55.9% and 29.7% at 1, 3, and 5 years, respectively, and overall survival rates were 100%, 93.4%, and 83.5% at 1, 3, and 5 years, respectively. Tumor size significantly predicted recurrence. No treatment-related death occurred.
Conclusions: Combination of RFA was an efficient and safe treatment for BCLC stage A HCC patients that failed to achieve complete response to initial TACE. We suggest TACE plus RFA be considered as a curative option for early HCC patients ineligible for curative resection of RFA.
Keywords: Hepatocellular carcinoma; Transarterial chemoembolization; Radiofrequency ablation; Treatment outcome

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