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J Vasc Interv Radiol. 2013 May;24(5):655-66. doi: 10.1016/j.jvir.2012.12.009. Epub 2013 Feb 18.

Survival with up to 10-year follow-up after combination therapy of chemoembolization and radiofrequency ablation for the treatment of hepatocellular carcinoma: single-center experience.

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Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.



To report 10-year outcomes of treating hepatocellular carcinomas (HCCs) by combination therapy of chemoembolization and radiofrequency (RF) ablation.


Combination therapy was administered in 277 patients with 382 treatment-naïve HCCs. Therapeutic effects, safety, survival rate, and prognostic factors were evaluated.


Tumor enhancement disappeared after 466 RF sessions in all tumors, resulting in a complete response rate of 100% (277 of 277) based on modified Response Evaluation Criteria In Solid Tumors. Local tumor progression developed in 15 patients (5.4%; 15 of 277) during the mean follow-up of 44.9 months±29.1 (range, 6.0-134.4 mo). Overall and recurrence-free survival rates were 56.3% (95% confidence interval [CI], 52.5%-60.2%) and 22.5% (95% CI, 19.3%-25.6%) at 5 years and 23.5% (95% CI, 17.7%-29.2%) and 9.3% (95% CI, 6.3%-12.4%) at 10 years. The Child-Pugh class was the only significant prognostic factor detected in both the univariate (P<.001) and the multivariate analyses (hazard ratio, 3.8; 95% CI, 2.5-5.6; P<.001). The 5-year and 10-year overall survival rates were 66.4% (95% CI, 62.0%-70.8%) and 30.6% (95% CI, 23.3%-37.9%) in 210 Child-Pugh class A patients. In addition to the Child-Pugh class, the maximum tumor diameter (≤3 cm vs>3 cm) and the tumor number (single vs multiple) were significant independent factors affecting recurrence-free survival. No death was related to the combination therapy. The major complication rate was 3.2% (15 of 466).


RF ablation combined with chemoembolization is a safe and useful therapeutic option for treating HCCs. Prognostic factors detected in this study help to stratify patients who benefit from this combination therapy.

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