Comparative study of radiofrequency ablation and percutaneous ethanol injection in treating postoperative recurrence of hepatocellular carcinoma

Objective To compare the clinical effects of radiofrequency ablation (RFA) and percutaneous ethanol injection (PEI) in treating postoperative recurrence of hepatocellular carcinoma (HCC) and to provide reference for clinical treatment of recurrent HCC. Methods A retrospective analysis was performed on the clinical data of 175 patients who had a single recurrent lesion after surgical treatment of HCC from August 2007 to January 2010. These patients were divided into PEI group (n=101) and RFA group (n=74) according to the modalities of treatment for recurrent HCC. All cases underwent color Doppler ultrasound and contrast-enhanced ultrasound or CT before and after treatment. The two groups were compared in terms of number of treatments, complete ablation rate, and complication rate. The 1-, 2-, and 3-year survival rates after treatment were also recorded. The measurement data were subjected to t-test, while the enumeration data were subjected to chi-square test. Results The PEI group had a significantly larger mean number of treatments than the RFA group (P＜0.05). There was no significant difference in complication rate between the two groups (P＞0.05). For the recurrent lesions smaller than 2.0 cm in diameter, the complete ablation rate showed no significant difference between the RFA group and PEI group (P＞0.05), while this rate was significantly higher in the RFA group than in the PEI group for the recurrent lesions with a diameter of 2.0-5.0 cm (P＜005). Among the patients with recurrent lesions smaller than 2.0 cm in diameter, those receiving PEI had 1-, 2-, and 3-year survival rates of 89.1%, 69.1%, and 49.1%, respectively, versus 90.2%, 70.7%, and 53.7% for those receiving RFA (P＞0.05); among the patients with recurrent lesions with a diameter of 2.0-5.0 cm, those receiving PEI had significantly lower 1-, 2-, and 3-year survival rates than those receiving RFA (63.0% vs 84.8%, P＜0.05; 43.5% vs 66.7%, P＜0.05; 21.7% vs 45.5%, P＜0.05). Conclusion RFA and PEI lead to similar survival rates in patients with recurrent lesions smaller than 2.0 cm in diameter after surgical treatment of HCC, but RFA produces a better survival than PEI in those with recurrent lesions with a diameter of 2.0-5.0 cm.