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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2015

01-04-2015 | Hepatobiliary Tumors

Cryoablation Provides Superior Local Control of Primary Hepatocellular Carcinomas of >2 cm Compared with Radiofrequency Ablation and Microwave Coagulation Therapy: An Underestimated Tool in the Toolbox

Authors: Shigenori Ei, MD, Taizo Hibi, MD, PhD, Minoru Tanabe, MD, PhD, Osamu Itano, MD, PhD, Masahiro Shinoda, MD, PhD, Minoru Kitago, MD, PhD, Yuta Abe, MD, PhD, Hiroshi Yagi, MD, PhD, Koji Okabayashi, MD, PhD, Daisuke Sugiyama, MD, PhD, Go Wakabayashi, MD, PhD, Yuko Kitagawa, MD, PhD

Published in: Annals of Surgical Oncology | Issue 4/2015

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Abstract

Background

Although cryoablation (Cryo) has been advocated as an effective locoregional therapy for hepatocellular carcinoma (HCC), few studies have compared the outcomes with those of radiofrequency ablation (RFA) and microwave coagulation therapy (MCT).

Methods

Consecutive patients with primary HCCs of <5 cm received Cryo or RFA/MCT between 1998 and 2011 and were monitored for local recurrence (defined as a recurrent tumor at or in direct contact with the ablated area) and overall complication rates.

Results

The median tumor size was 2.5 cm in the Cryo group (n = 55) and 1.9 cm in the RFA/MCT group (n = 64; P < 0.001), but other patient characteristics were similar. Multivariate Cox regression analysis revealed Cryo as the only independent factor for improved 2-year local recurrence-free survival, with a hazard ratio (HR) of 0.3 (95 % confidence interval, 0.1–0.9; P = 0.02). Tumor diameter was a negative indicator of local recurrence-free survival (HR, 2.0; 95 % confidence interval, 1.1–3.5; P = 0.02). Subgroup analysis of patients with tumors of >2 cm demonstrated significantly better local recurrence rates in the Cryo group compared with the RFA/MCT group (21 vs. 56 % at 2 years; P = 0.006). Overall complication rates and incidences of Clavien–Dindo classification grade ≥III were identical (both P = 1.00). No in-hospital mortality occurred.

Conclusions

Appropriate use of Cryo, as shown in this series, is safe and provides significantly improved local control for the treatment of primary HCCs of >2 cm compared with RFA/MCT.
Appendix
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Metadata
Title
Cryoablation Provides Superior Local Control of Primary Hepatocellular Carcinomas of >2 cm Compared with Radiofrequency Ablation and Microwave Coagulation Therapy: An Underestimated Tool in the Toolbox
Authors
Shigenori Ei, MD
Taizo Hibi, MD, PhD
Minoru Tanabe, MD, PhD
Osamu Itano, MD, PhD
Masahiro Shinoda, MD, PhD
Minoru Kitago, MD, PhD
Yuta Abe, MD, PhD
Hiroshi Yagi, MD, PhD
Koji Okabayashi, MD, PhD
Daisuke Sugiyama, MD, PhD
Go Wakabayashi, MD, PhD
Yuko Kitagawa, MD, PhD
Publication date
01-04-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 4/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4114-7

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