Percutaneous radiofrequency ablation versus repeat hepatectomy for recurrent hepatocellular carcinoma: a retrospective study.
BACKGROUND
Whether percutaneous radiofrequency ablation (PRFA) is as effective as repeat hepatectomy for recurrent small hepatocellular carcinoma (HCC) in the long-term remains unknown.


METHODS
We included 110 patients into this study. Each patient had fewer than three recurrent HCCs, with the largest tumor less than 5 cm in diameter. Sixty-six patients with 88 tumors were treated by PRFA and 44 patients with 55 tumors were treated by repeat hepatectomy.


RESULTS
The 1-, 2-, 3-, 4-, and 5-year overall survival rates after repeat hepatectomy and PRFA were 78.6%, 56.8%, 44.5%, 30.7%, and 27.6%, and 76.6%, 48.6%, 48.6%, 39.9%, and 39.9%, respectively (P = 0.79). The 1-, 2-, 3-, 4-, and 5-year overall survival rates after the initial hepatectomy for the two groups were 95.4%, 79.1%, 65.0%, 50.4%, and 42.9%, and 98.5%, 85.0%, 70.8%, 58.7%, and 55.6%, respectively, (P = 0.18). Subgroup analyses showed that there was no significant difference between the overall survivals of the two groups of patients when the interval of tumor recurrence from the initial hepatectomy was <or=1 year (P = 0.74) or >1 year (P = 0.69), and for recurrent tumor <or=3 cm (P = 0.62) or >3 cm (P = 0.57). Major complications happened significantly more often after repeat hepatectomy than PRFA (30 of 44 versus 2 of 66, P < 0.05). The interval of recurrence from the initial hepatectomy, the diameter of the recurrent tumor and the serum albumin level were significant prognostic factors for overall survival.


CONCLUSIONS
PRFA was as effective as repeat hepatectomy in the treatment of recurrent small HCC. PRFA had the advantage over repeat hepatectomy in being less invasive.
Liang
Hui-Hong
HH
State Key Laboratory of Oncology in Southern China, Guangzhou, People's Republic of China.
Chen
Min-Shan
MS
Peng
Zhen-Wei
ZW
Zhang
Yao-Jun
YJ
Zhang
Ya-Qi
YQ
Li
Jin-Qing
JQ
Lau
Wan Yee
WY
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D055815:Young Adult