No-touch RFA Versus Traditional RFA for Small Hepatocellular Carcinoma

Study Overview
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Brief Summary
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Traditional RFA treatment has been a curable therapy for small hepatocellular carcinoma (diameter≤3cm). This technique ablates the tumor via radio frequency by inserting an electrode needle directly into the tumor. This clearly violates no-touch technique based on the principle of surgical oncology. Thus the 1-year recurrence rate of the cancer is up to 30% after the treatment, and the 3-year tumor-free survival rate is only 20% - 40%. No-touch RFA treatment avoids the direct contact with the tumor that can cause the spread of cancer cells in the liver, or the Antrim spread, Therefore it has been suggested that no-touch RFA treatment reduce the recurrence rate after operation in comparison with the traditional RFA treatment. This research project aims at using the prospective randomized comparative method to compare the short-term and the long-term curative effects between no-touch RFA and traditional RFA treatments for small hepatic carcinoma.

Official Title
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Prospective Randomized Comparative Study on No-touch Radiofrequency Ablation Treatment of Small Hepatocellular Carcinoma

Conditions
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Hepatocellular Carcinoma

Intervention / Treatment
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* Procedure: Traditional RFA
* Procedure: No-touch RFA


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Primary hepatocellular carcinoma, according to the postoperative pathological examination as the standard, or the diagnostic criteria with reference to the 2012 American Association for the Study of Liver Diseases if the pathological evidence is not available; A single tumor with a diameter ≤3cm; The tumor that has not invaded the portal vein, the hepatic vein, or the secondary branch; Liver function classified as Child A or B; Liver reserve function test with ICG-R15 (indocyanine green retention at 15min) ≤30%, and the important organs that can function with the tolerance of RFA or partial hepatectomy; No significant coagulopathy: platelet count > 50,000,000,000 /L, prolonged prothrombin time < 5 seconds; Age 18 - 70 years old; No acceptance of other anti-cancer therapy before the treatment. Exclusion Criteria: Complication of severe portal hypertension: a history of upper gastrointestinal bleeding, a history of severe hypersplenism, or refractory ascites; Patients with extrahepatic metastasis or lymph node metastasis; Patients with multiple liver tumors found from imaging exam or during the treatment; Patients with pathological examinations showing the other tissue type of liver cancer after the treatment; Patients who expect to receive a liver transplant; Patients whose preoperative imaging exam indicates the tumor close to the gallbladder, hilar major blood vessels, bile ducts and surrounding vital organs, with a potential of serious injury by mistake or serious complications during the treatment.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Traditional RFA<br>Using Traditional RFA for the treatment of small hepatocellular carcinoma | Procedure: Traditional RFA<br>* Radio frequency ablation via an ultrasound-guided electrode needle penetrating into the lesion center<br>* Other names: RFA;|
| Experimental: No-touch RFA<br>Using No-touch RFA for the treatment of small hepatocellular carcinoma | Procedure: No-touch RFA<br>* Radio frequency ablation via an ultrasound-guided electrode needle penetrating into the tumor-free zone (within 5mm along the edge of the tumor)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Recurrence Rate |  | 3 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Recurrence-free Survival Rate |  | 3 years | 
| Overall Survival Rate |  | 3 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Small Hepatocellular Carcinoma, No-touch RFA, Traditional RFA, Recurrence rate