title: Surgical resection vs. percutaneous ablation for hepatocellular carcinoma: a preliminary report of the Japanese nationwide survey.
abstract: OBJECTIVE
  The treatment of choice for HCC remains controversial. We evaluated the therapeutic impact of surgical resection, PEI, and RFA for HCC on outcomes.
  
  
  METHODS
  A database derived from a Japanese nationwide survey of 17,149 patients with HCC treated by resection, PEI, or RFA between 2000 and 2003 was used to identify 7185 patients with no more than 3 tumors (< or = 3 cm) and a liver function of Child-Pugh class A or B. The patients classified into either a resection (n=2857), RFA (n=3022), or PEI group (n=1306) and their long-term outcomes were compared.
  
  
  RESULTS
  The median follow-up period was 10.4 months. The 2-year time-to-recurrence rate was 35.5%, 55.4%, and 73.3% in the resection, RFA, and PEI groups, respectively, while the number of recurrences was 2410, 2368, and 862. Although the number of deaths was 55 (1.9%), 49 (1.6%), and 39 (3.0%), the overall survival rates were not different. In a multivariate analysis, surgical resection was a significant negative factor for recurrence as compared with RFA (relative risk, 0.62 [95% confidence interval, 0.54-0.71], P<0.0001) and PEI (0.45 [0.38-0.52], P<0.0001).
  
  
  CONCLUSIONS
  This preliminary report suggested that surgical resection may provide less time-to-recurrence rate than either RFA or PEI in patients with HCC.
authors.affiliation: Department of Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.forename: Shigeki
authors.initials: S
authors.lastname: Arii
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Okazaki
authors.forename: Kiwamu
authors.initials: K
authors.lastname: Okita
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
authors.forename: Masamichi
authors.initials: M
authors.lastname: Kojiro
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
authors.forename: Kenichi
authors.initials: K
authors.lastname: Takayasu
authors.forename: Morito
authors.initials: M
authors.lastname: Monden
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Matsuyama
authors.forename: Iwao
authors.initials: I
authors.lastname: Ikai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000208:ethnology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D002492:Central Nervous System Depressants / Q000008:administration & dosage / Q000627:therapeutic use; D013505:Digestive System Surgical Procedures / Q000379:methods*; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006306:Health Surveys; D006801:Humans; D007267:Injections; D007564:Japan; D008113:Liver Neoplasms / Q000188:drug therapy / Q000208:ethnology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol