Comparing the outcomes of radiofrequency ablation and surgery in patients with a single small hepatocellular carcinoma and well-preserved hepatic function.
OBJECTIVE
To compare the efficacy of radiofrequency ablation (RFA) and surgical resection in a group of patients with a Child-Pugh score of 5 and a single HCC less than 4 cm in diameter.


BACKGROUND
Radiofrequency ablation (RFA) has become a popular method for treatment of hepatocellular carcinoma (HCC) and has been applied as an alternative primary therapy to surgical resection.


METHODS
We compared outcomes for 148 patients treated with RFA (n = 55) and those treated surgically (n = 93).


RESULTS
The rate of local recurrence among patients in the RFA group was significantly higher than in the surgery group (P = 0.005), while the incidence of remote recurrence was similar between the two groups (P = 0.30). The cumulative 1- and 3-year overall survival rates (P = 0.24) and the cumulative 1- and 3-year recurrence-free survival rates (P = 0.54) were not significantly different between the two groups.


CONCLUSIONS
Despite a higher rate of local recurrence, RFA was found to be as effective as surgical resection for the treatment of single small HCC in patients with well-preserved liver function, in terms of the incidence of remote recurrence and the patients' likelihood of achieving overall and/or recurrence-free survival.
Hong
Sung Noh
SN
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea.
Lee
Sun-Young
SY
Choi
Moon Seok
MS
Lee
Joon Hyeok
JH
Koh
Kwang Cheol
KC
Paik
Seung Woon
SW
Yoo
Byung Chul
BC
Rhee
Jong Chul
JC
Choi
Dongil
D
Lim
Hyo Keun
HK
Lee
Kwang-Woong
KW
Joh
Jae Won
JW
D006528:Carcinoma, Hepatocellular / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged