Efficacy of percutaneous ethanol injection versus radiofrequency ablation for single hepatocellular carcinoma no larger than 5 cm

OBJECTIVE: To compare the efficacy of percutaneous ethanol injection (PEI) and radiofrequency ablation (RFA) for patients with hepatocellular carcinoma (HCC) of no larger than 5 cm. METHODS: The data used in this study were retrieved from the SEER database. In total, 3510 patients diagnosed with HCC of no larger than 5 cm who received PEI or RFA were included. RESULTS: The median overall survival (mOS) and median cancer-specific survival (mCSS) of RFA-treated patients were not significantly longer than those of PEI-treated patients either before or after propensity score matching (PSM). The subgroup analysis showed that patients with HCC of no larger than 2 cm, HCC of larger than 2 cm, American Joint Committee on Cancer (AJCC) stage I and II, and AJCC stage III and IV who received RFA had mOS and mCSS similar to those of patients who received PEI after PSM. Multivariable regression analysis showed that PEI did not increase the all-cause mortality risk or cancer-specific mortality risk after PSM. CONCLUSION: RFA is still the better choice for patients with a single HCC of no more than 5 cm. However, PEI might be a good choice for these patients who cannot be treated with RFA.