Radiofrequency ablation versus surgical resection for hepatocellular carcinoma in Childs A cirrhotics-a retrospective study of 1,061 cases.
BACKGROUND
The long-term outcomes of radiofrequency ablation (RFA) vs. surgical resection in cirrhotic patients with hepatocellular carcinoma (HCC) remain controversial. One thousand sixty-one cirrhotic HCC patients were included into a retrospective study. Four hundred thirteen received RFA and 648 received surgical resection.


RESULTS
Overall (OS), recurrence-free (RFS), and tumor-free survival (TFS) were compared between the two groups and in subgroup analyses. The 5-year OS and corresponding RFS as well as DFS were significantly higher in the surgical resection group compared with the RFA group (p < 0.001, p < 0.001, p < 0.001). In subgroup analyses of solitary HCC ≤3 cm, there was no significant difference in RFS between the two groups (p = 0.719). Nonetheless, surgical resection was superior to RFA for OS and TFS in this subgroup as well as for OS, RFS, and TFS in subgroup analyses for solitary lesions 3 cm < HCC < 5 cm and multifocal HCC. Serum AFP was the only significant predicting factor for all survival analyses.


CONCLUSIONS
When treating Childs A cirrhotic patients with solitary HCC larger than 3 cm but less than 5 cm, or with two or three lesions each less than 5 cm, surgical resection provides a better survival than RFA. When treating Childs A cirrhotics with solitary HCC ≤ 3 cm, RFA has a comparable RFS to surgical resection, but RFA is less invasive.
Department of Hepato-Biliary-Pancreatic Surgery, Treatment Centre of Liver Cancer, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Jiwei
J
Huang
Roberto
R
Hernandez-Alejandro
Kristopher P
KP
Croome
Lvnan
L
Yan
Hong
H
Wu
Zheyu
Z
Chen
Pankaj
P
Prasoon
Yong
Y
Zeng
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D018572:Disease-Free Survival; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000150:complications / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery / Q000628:therapy; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D000509:alpha-Fetoproteins / Q000378:metabolism
D000509:alpha-Fetoproteins