Page 24 - Read Online

Naeem et al. Hepatoma Res 2018;4:18 I http://dx.doi.org/10.20517/2394-5079.2018.22 Page 7 of 10

Table 3. Differences in outcome following RFA and PEI, as reported by an Italian study comprising of 271 patients with a
single lesions up to 3 cm in size. Adapted from reference [62]
RFA PEI
Number of patients 128 143
3-year survival 83 78
5-year survival 70 68
Average number of sessions 5 8
Rate of major complications 0.9% 1.9%
Recurrence rate at 3 years 7.8 9.4
PEI: percutaneous ethanol injection; RFA: radiofrequency ablation

CONCLUSION
While surgical resection is still considered the standard of care for patients with early stage Hepatocellular
carcinoma, percutaneous ablation has emerged as a viable alternative for the management of patients who
are poor surgical candidates. Among percutaneous therapies, radiofrequency ablation has now replaced
percutaneous ethanol injection as the treatment of choice for patients with BCLC 0-A tumors, not amenable
to surgical resection, while ethanol injection is still recommended in cases where RFA is not technically
feasible due to the inaccessible location of the lesions.

Radiofrequency ablation has shown the best results when used for smaller tumors, particularly those smaller
than 3 cm. While the percutaneous approach is employed most frequently, RFA can be administered via the
laparoscopic or open approach as well, preferred in case of lesions located near the inferior edge of the liver,
in close proximity to adjacent organs. Other emerging loco-regional procedures like microwave ablation,
percutaneous laser ablation and cryotherapy are not as widely available and have not been studied as well.

DECLARATIONS
Authors’ contributions
Developed the first draft: Naeem E
Modified and layout the concepts of tables and figure: Abid S
Reviewed the subsequent versions and final draft: Naeem E, Abid S

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
Both authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2018.