Survival Analysis of High-Intensity Focused Ultrasound Therapy Versus Radiofrequency Ablation in the Treatment of Recurrent Hepatocellular Carcinoma

Objective: To evaluate our preliminary experience of high-intensity focused ultrasound (HIFU) for the treatment of recurrent hepatocellular carcinoma (HCC). Background: HIFU is a new thermal ablative therapy for HCC. Whether it incurs survival benefit similar to that of radio frequency ablation (RFA) remains uncertain. Methods: Clinicopathological data of 27 patients who received HIFU ablation and 76 patients who received RFA for recurrent HCC from October 2006 to October 2009 were reviewed. Survival outcomes between the 2 groups were compared using the log-rank test. A value of P < 0.05 was considered significant. Results: The median follow-up was 27.9 months. There was no difference in tumor size (HIFU, 1.7 cm; RFA, 1.8 cm; P = 0.28) between the 2 groups. Procedure-related morbidity rate was 7.4% in the HIFU group and 6.5% in the RFA group (P = 1.00). Skin burn and pleural effusion were the 2 morbidities associated with HIFU. There was no hospital mortality in the HIFU group, whereas 2 deaths occurred in the RFA group. The 1-, 2-, and 3-year disease-free survival rates were 37.0%, 25.9%, and 18.5%, respectively, for the HIFU group, and 48.6%, 32.1%, and 26.5%, respectively for the RFA group (P = 0.61). The 1-, 2-, and 3-year overall survival rates were 96.3%, 81.5%, and 69.8%, respectively, for the HIFU group, and 92.1%, 76.1%, and 64.2%, respectively, for the RFA group (P = 0.19). Conclusions: Our preliminary experience in using HIFU for recurrent HCC is promising. Further studies are needed to explore its treatment value for primary HCC.