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Radiofrequency Treatment Better Than Ethanol Injection for Small Liver Tumours HOBOKEN, NJ -- February 4, 2009 -- A review of 4 randomised controlled trials that directly compared 2 different treatments for small inoperable liver tumours found that radiofrequency ablation (RFA) significantly improves patient survival compared with percutaneous ethanol injection (PEI). The findings are published in the February issue of Hepatology. Guidelines from the American Association for the Study of Liver Diseases (AASLD) recommend PEI as a safe and highly effective treatment for small hepatocellular carcinomas and say it is the standard against which new therapies should be compared. Yun Ku Cho, MD, Department of Radiology, Seoul Veterans Hospital, Seoul, Korea, and colleagues conducted a systematic review and meta-analysis of randomised controlled trials to determine the benefit of RFA compared with PEI. Using databases and manual searches, they identified all relevant, peer-reviewed studies published from 1978 through July 2008. Ultimately, only 4 studies, which included a total of 652 patients, contained enough information for a meta-analysis of 3-year overall survival. "Most randomised controlled trials identified definite survival benefit favoring RFA compared with PEI except the latest trial published in 2008," the authors said. The meta-analysis also detected a significant improvement in 3-year survival for patients who underwent RFA. "The additional survival benefit of RFA can be attributed to improved local tumour response of RFA, which in turn can be explained by the fact that more predictable tumour ablation was possible," the authors suggested. While injected ethanol might be stopped by the liver's fibrous septum or by satellite nodules, the heat from the radiofrequency electrode tip is distributed more homogenously. SOURCE: Wiley-Blackwell E-mail this page to a friend or colleague! To print, use this version