Comparisons of Radiofrequency Ablation, Microwave Ablation, and Irreversible Electroporation by Using Propensity Score Analysis for Early Stage Hepatocellular Carcinoma
by
,
Takuya Wada
1, 
Katsutoshi Sugimoto
1,*,
Kentaro Sakamaki
2,
Hiroshi Takahashi
1,
Tatsuya Kakegawa
1,
Yusuke Tomita
1,
Masakazu Abe
1,
Yu Yoshimasu
1,
Hirohito Takeuchi
1 and
Takao Itoi
1 
1
Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
2
Center for Data Science, Yokohama City University, 22-2 Seto, Kanazawa-ku, Yokohama-shi 236-0027, Kanagawa, Japan
*
Author to whom correspondence should be addressed.
Cancers 2023, 15(3), 732; https://doi.org/10.3390/cancers15030732
Submission received: 10 December 2022
/
Revised: 20 January 2023
/
Accepted: 21 January 2023
/
Published: 25 January 2023
(This article belongs to the Section Cancer Therapy)
Simple Summary
This single-center retrospective study aimed to compare the therapeutic and safety outcomes of radiofrequency ablation (RFA), microwave ablation (MWA), and irreversible electroporation (IRE) in the treatment of early stage hepatocellular carcinoma (HCC) using propensity score-matched analysis to reduce selection bias. A significant difference in 2-year local tumor progression (LTP) rates between the IRE and RFA groups (IRE, 0.0% vs. RFA, 45.0%; p = 0.005) was found. There was no significant difference in 2-year LTP rates between the IRE and MWA groups (IRE, 0.0% vs. MWA, 25.0%; p = 0.103) as well as between the RFA and MWA groups (RFA, 18.2% vs. MWA, 20.6%; p = 0.586). IRE provides better local tumor control than RFA as a first-line therapeutic option for small perivascular HCC.
Abstract
Background: Despite the diversity of thermal ablations, such as radiofrequency ablation (RFA) and microwave ablation (MWA), and non-thermal ablation, such as irreversible electroporation (IRE) cross-comparisons of multiple ablative modalities for hepatocellular carcinoma (HCC) treatment remain scarce. Thus, we investigated the therapeutic outcomes of different three ablation modalities in the treatment of early stage HCC. Methods: A total of 322 consecutive patients with 366 HCCs (mean tumor size ± standard deviation: 1.7 ± 0.9 cm) who underwent RFA (n = 216, 59.0%), MWA (n = 91, 28.3%), or IRE (n = 15, 4.7%) were included. Local tumor progression (LTP) rates for LTP were compared among the three modalities. Propensity score-matched analysis was used to reduce selection bias. Results: A significant difference in 2-year LTP rates between the IRE and RFA groups (IRE, 0.0% vs. RFA, 45.0%; p = 0.005) was found. There was no significant difference in 2-year LTP rates between the IRE and MWA groups (IRE, 0.0% vs. MWA, 25.0%; p = 0.103) as well as between the RFA and MWA groups (RFA, 18.2% vs. MWA, 20.6%; p = 0.586). Conclusion: IRE provides better local tumor control than RFA as a first-line therapeutic option for small perivascular HCC.
