title: Treatment strategy for early hepatocellular carcinomas: comparison of radiofrequency ablation with or without transcatheter arterial chemoembolization and surgical resection.
abstract: BACKGROUND
  The preferred choice between surgical treatment and radiofrequency ablation (RFA) for the treatment of small resectable hepatocellular [corrected] carcinoma (HCC) has become a subject for debate.
  
  
  METHODS
  We compared the results of hepatic resection (n = 199) with those of RFA (n = 87), of which 69 patients were treated with transcatheter arterial chemoembolization followed by RFA, for 286 patients with 3 or fewer nodules, none of which exceeded 3 cm in diameter at Hiroshima University Hospital.
  
  
  RESULTS
  In subgroup analysis of single HCC with tumor size exceeding 2 cm in Child-Pugh class A, the disease-free survival time was significantly longer in the surgical resection group than in the RFA group (P = 0.048). In the subgroups of a single and multiple HCC with tumor size ≤2 cm in Child-Pugh class A, the overall and disease-free survival rates were almost the same for the surgical resection and RFA groups (P = 0.46 and 0.58, respectively, in single HCC, and P = 0.98 and 0.98, respectively, in multiple HCC).
  
  
  CONCLUSIONS
  Surgical resection may provide better long-term disease-free survival than RFA in the subgroup of a single HCC exceeding 2 cm of Child-Pugh class A.
authors.affiliation: Department of Gastroenterological Surgery, Hiroshima University Hospital 1-2-3, Kasumi, Hiroshima, Japan. htashiro@hiroshima-u.ac.jp
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tashiro
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.forename: Koji
authors.initials: K
authors.lastname: Waki
authors.forename: Hironobu
authors.initials: H
authors.lastname: Amano
authors.forename: Akihiko
authors.initials: A
authors.lastname: Oshita
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Yoshisato
authors.initials: Y
authors.lastname: Tanimoto
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kuroda
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tazawa
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Asahara
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000556:secondary / Q000628:therapy*; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents