Treatment of small HCC through radiofrequency ablation and laser ablation. Comparison of techniques and long-term results.

Purpose: The aim of this trial was to compare the results obtained using laser ablation (LA) and radiofrequency ablation (RFA) to treat small hepatocellular carcinomas (HCC).
Materials and Methods: From 2003 to 2005, a total of 81 cirrhotic patients (59 Child-Pugh A, 22 Child-Pugh B) presenting a total of 95 HCC nodules (mean diameter 27.9 mm) were treated with LA (41) and RFA (40).
Results: Computed tomography (CT) revealed complete tumour ablation in 78% of nodules treated with LA and in 94% of those treated with RA; the disease-free interval was 16.50+/-8.1 months. The cumulative survival rates were 91.8%, 59% and 28.4% at 12, 36 and 60 months, respectively. The patients treated with RFA had better survival rates than those treated with LA, although this difference was not statistically significant (p=0.3299). Univariate analysis of survival revealed statistically significant differences between the Child-Pugh A and B groups (p<0.0001), between HCC nodules measuring < or =25 mm and >25 mm (p=0.0001) and between patients with a single nodule and with two nodules (p=0.0484).
Conclusions: We found LA and RFA to be equally effective. However, RA appears more suited to patients with small HCC nodules and in Child-Pugh class A.