title: Radiofrequency ablation versus surgical resection for the treatment of hepatocellular carcinoma in cirrhosis.
abstract: OBJECTIVE
  Percutaneous radiofrequency ablation (RFA) demonstrated good results for the treatment of hepatocellular carcinoma (HCC) in cirrhotic patients; it is still not clear whether the overall survival and disease-free survival after RFA are comparable with surgical resection. The aims of this study are to compare the overall survival and disease-free survival in two groups of cirrhotic patients with HCC submitted to surgery or RFA.
  
  
  METHODS
  Two hundred cirrhotic patients with HCCs smaller than 6 cm were included in this retrospective study: 109 underwent RFA and 91 underwent surgical resection at a single Division of Surgery of University of Verona.
  
  
  RESULTS
  Median follow-up time was 27 months. Overall survival was significantly longer in the resection group in comparison with the RFA group with a median survival of 57 and 28 months, respectively (P=0.01). In Child-Pugh class B patients and in patients with multiple HCC, survival was not significantly different between the two groups. In patients with HCC smaller than 3 cm, the overall survival and disease-free survival for RFA and resection were not significantly different in univariate and multivariate analysis. Whereas in patients with HCC greater than 3 cm, surgery showed improvement in outcome in both univariate and multivariate analysis.
  
  
  CONCLUSIONS
  Surgical resection significantly improves the overall survival and disease-free survival in comparison with RFA. In a selected group of patients (Child-Pugh class B, multiple HCC, or in HCC<or=3 cm), the results between the two treatments did not show significant differences.
authors.affiliation: Division of General Surgery A, Department of Surgery and Gastroenterology, University of Verona Medical School, GB Rossi University Hospital, Piazzale LA Scuro 10, 37134, Verona, Italy. alfredo.guglielmi@univr.it
authors.forename: Alfredo
authors.initials: A
authors.lastname: Guglielmi
authors.forename: Andrea
authors.initials: A
authors.lastname: Ruzzenente
authors.forename: Alessandro
authors.initials: A
authors.lastname: Valdegamberi
authors.forename: Silvia
authors.initials: S
authors.lastname: Pachera
authors.forename: Tommaso
authors.initials: T
authors.lastname: Campagnaro
authors.forename: Mirko
authors.initials: M
authors.lastname: D'Onofrio
authors.forename: Enrico
authors.initials: E
authors.lastname: Martone
authors.forename: Paola
authors.initials: P
authors.lastname: Nicoli
authors.forename: Calogero
authors.initials: C
authors.lastname: Iacono
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome