To compare the clinical efficacy, safety and economic benefit of high-intensity focused ultrasound (HIFU), argon-helium cryoablation and radiofrequency ablation (RFA) in the treatment of small liver cancer.

Clinical data of 176 patients with small liver cancer undergoing local ablation in the First Affiliated Hospital of Zhengzhou University from December 2009 to September 2014 were retrospectively analyzed. Among them, 142 patients were male and 34 female, aged (55±11) years on average. The informed consents of all patients were obtained and the local ethical committee approval was received. 57 patients were assigned in HIFU group, 54 in argon-helium group and 65 in RFA group. The hospitalization expenses was compared among three groups with analysis of variance, and the postoperative efficacy and incidence of complications were compared with Chi-square test. Survival analysis was conducted with Kaplan-Meier and Log-rank test.

At postoperative 1 month, the complete tumor ablation rates were 90%, 89% and 94%, and the AFP reduction rates were 76%, 72% and 83% in HIFU, argon-helium and RFA groups, respectively, where no significant difference was observed among three groups (χ²=1.086, 1.417; P>0.05). Grade Ⅲ skin burn was noted in 1 case in HIFU group, 1 case of needle bleeding and 2 cases of acute kidney injury in argon-helium group, and 1 case of abdominal bleeding in RFA group. No significant difference was observed in the incidence of D-F grade severe complications among three groups (χ²=1.893, P>0.05). The 1-, 2-, 3-year overall survival rates were 87.8%, 72.4%, 59.4% in HIFU group, and were 87.7%, 77.7%, 58.9% in argon-helium group, 93.6%, 77.4%, 60.4% in RFA group, where no significant difference was observed among three groups (χ²=0.315, P>0.05). The 1-, 2-, 3-year tumor-free survival rates were 81.2%, 66.3%, 46.4% in HIFU group, which did not significantly differ from 80.7%, 64.2%, 55.1% in argon-helium group, and 84.5%, 72.1%, 52.1% in RFA group (χ²=5.382, P>0.05). The hospitalization expenses were respectively (3.0±1.2)×10⁴, (3.2±1.2)×10⁴ and (3.6±1.3)×10⁴ Yuan in HIFU, argon-helium and RFA groups, where significant difference was observed among three groups (F=7.72, P<0.05).

Three kinds of ablation are safe and efficacious in the treatment of small liver cancer. HIFU requires less hospitalization expenses compared with argon-helium cryoablation and RFA.