Radiofrequency Ablation Using a Separable Clustered Electrode for the Treatment of Hepatocellular Carcinomas: A Randomized Controlled Trial of a Dual-Switching Monopolar Mode Versus a Single-Switching Monopolar Mode |
| |
| Authors: | Jae Won Choi Jeong Min Lee Dong Ho Lee Jung-Hwan Yoon Yoon Jun Kim Jeong-Hoon Lee Su Jong Yu Eun Ju Cho |
| |
| Affiliation: | 1.Department of Radiology, Seoul National University Hospital, Seoul, Korea.;2.Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.;3.Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.;4.Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.;5.Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea. |
| |
| Abstract: | ObjectiveThis study aimed to prospectively compare the efficacy, safety, and mid-term outcomes of dual-switching monopolar (DSM) radiofrequency ablation (RFA) to those of conventional single-switching monopolar (SSM) RFA in the treatment of hepatocellular carcinoma (HCC).Materials and MethodsThis single-center, two-arm, parallel-group, randomized controlled study was approved by the Institutional Review Board. Written informed consent was obtained from all patients upon enrollment. A total of 80 patients with 94 HCC nodules were randomized into either the DSM-RFA group or SSM-RFA group in a 1:1 ratio, using a blocked randomization method (block size 2). The primary endpoint was the minimum diameter of the ablation zone per unit time. The secondary endpoints included other technical parameters, complication rate, technique efficacy, and 2-year clinical outcomes.ResultsSignificantly higher ablation energy per unit time was delivered to the DSM-RFA group than to the SSM-RFA group (1.7 ± 0.2 kcal/min vs. 1.2 ± 0.3 kcal/min; p < 0.001). However, no significant differences were observed between the two groups for the analyzed variables, including primary endpoint, regarding size of the ablation zone and ablation time. Major complication rates were 4.9% in the DSM-RFA group and 2.6% in the SSM-RFA group (p = 1.000). The 2-year local tumor progression (LTP) rates of the HCC nodules treated using DSM-RFA and SSM-RFA were 8.5% and 4.7%, respectively (p = 0.316). The 2-year LTP-free survival rates of patients in the DSM-RFA and SSM-RFA groups were 90.0% and 94.4%, respectively (p = 0.331), and the 2-year recurrence-free survival rates were 54.9% and 75.7%, respectively (p = 0.265).ConclusionAlthough DSM-RFA using a separable clustered electrode delivers higher ablation energy than SSM-RFA, its effectiveness failed to show superiority over SSM-RFA in the treatment of HCC. |
| |
| Keywords: | Hepatocellular carcinoma Radiofrequency ablation Randomized controlled trial |
|
|
