Survival analysis of high-intensity focused ultrasound therapy vs. transarterial chemoembolization for unresectable hepatocellular carcinomas

Background & Aims High‐intensity focused ultrasound (HIFU) ablation is a non‐invasive treatment for unresectable hepatocellular carcinomas (HCCs), but long‐term survival analysis is lacking. This study was to analyse its outcome compared to that of transarterial chemoembolization (TACE). Methods From October 2003 to September 2010, 113 patients received HIFU ablation as a treatment of HCCs at our hospital. Twenty‐six patients had HCCs sized 3–8 cm. Fifty‐two patients with matched tumour characteristics having TACE as primary treatment were selected for comparison. Short‐term outcome and long‐term survival were analysed. Results In the HIFU group (n = 26), 46 tumours were ablated. The median age of the patients was 69 (49–84) years. The median tumour size was 4.2 (3–8) cm. In the TACE group (n = 52), the median age of the patients was 67 (44–84) years. The median tumour size was 4.8 (3–8) cm. There was no hospital mortality in any of the groups. In the HIFU group, the rates of complete tumour response, partial tumour response, stable disease and progressive disease were 50%, 7.7%, 25.6% and 7.7% respectively, according to the modified Response Evaluation Criteria in Solid Tumours. The TACE group had the corresponding rates at 0%, 21.2%, 63.5% and 15.4% respectively (P