Survival analysis of high-intensity focused ultrasound therapy vs. transarterial chemoembolization for unresectable hepatocellular carcinomas
Article first published online: 14 FEB 2014
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Volume 34, Issue 6, pages e136–e143, July 2014
How to Cite
Liver Int. 2014: 34: e136–e143
- Issue published online: 17 JUN 2014
- Article first published online: 14 FEB 2014
- Accepted manuscript online: 22 JAN 2014 09:08AM EST
- Manuscript Accepted: 16 JAN 2014
- Manuscript Received: 10 SEP 2013
- liver cancer;
- non-invasive treatment;
Background & Aims
High-intensity focused ultrasound (HIFU) ablation is a non-invasive treatment for unresectable hepatocellular carcinomas (HCCs), but long-term survival analysis is lacking. This study was to analyse its outcome compared to that of transarterial chemoembolization (TACE).
From October 2003 to September 2010, 113 patients received HIFU ablation as a treatment of HCCs at our hospital. Twenty-six patients had HCCs sized 3–8 cm. Fifty-two patients with matched tumour characteristics having TACE as primary treatment were selected for comparison. Short-term outcome and long-term survival were analysed.
In the HIFU group (n = 26), 46 tumours were ablated. The median age of the patients was 69 (49–84) years. The median tumour size was 4.2 (3–8) cm. In the TACE group (n = 52), the median age of the patients was 67 (44–84) years. The median tumour size was 4.8 (3–8) cm. There was no hospital mortality in any of the groups. In the HIFU group, the rates of complete tumour response, partial tumour response, stable disease and progressive disease were 50%, 7.7%, 25.6% and 7.7% respectively, according to the modified Response Evaluation Criteria in Solid Tumours. The TACE group had the corresponding rates at 0%, 21.2%, 63.5% and 15.4% respectively (P < 0.0001). The 1-year, 3-year and 5-year survival rates were 84.6%, 49.2% and 32.3% respectively, in the HIFU group and 69.2%, 29.8% and 2.3% respectively, in the TACE group (P = 0.001).
HIFU ablation is a safe and effective method for unresectable HCCs. A survival benefit is observed over sole TACE.