title: Endoscopic versus open radiofrequency ablation for treatment of small hepatocellular carcinoma.
abstract: BACKGROUND
  Surgical radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is associated with superior oncological outcome in comparison with percutaneous RFA. The present study aimed to retrospectively evaluate the relative perioperative safety and postoperative outcome of the laparoscopic or thoracoscopic approach versus the open approach to RFA for small HCC.
  
  
  METHODS
  A retrospective analysis was performed in 55 consecutive patients who underwent open (n = 32) or laparoscopic/thoracoscopic (LTS) RFA (n = 23) for primary unresectable HCC between January 2005 and December 2010. Baseline characteristics, survival/recurrence rates, and complications after treatment were compared between the two groups.
  
  
  RESULTS
  There was a trend showing that LTS RFA was performed for tumors located in the anterior segment (e.g., segments III, V, VIII). The LTS RFA group had a significantly lower intraoperative blood loss, shorter operative time, and shorter postoperative hospital stay, compared with the open RFA group. No major postoperative complications occurred in patients who underwent LTS RFA. No significant differences in overall survival, recurrence-free survival and local recurrence rates were observed between the two groups.
  
  
  CONCLUSIONS
  In consideration of operative invasiveness and postoperative recovery, LTS RFA is superior to the open approach in patients with small HCC. Moreover, the surgical outcome did not differ between the two approaches. Laparoscopic/thorascopic RFA can be considered to be a useful procedure for ablation therapy.
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan. sakoda@m.kufm.kagoshima-u.ac.jp
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sakoda
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ueno
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iino
authors.forename: Koji
authors.initials: K
authors.lastname: Minami
authors.forename: Kei
authors.initials: K
authors.lastname: Ando
authors.forename: Yota
authors.initials: Y
authors.lastname: Kawasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kurahara
authors.forename: Yukou
authors.initials: Y
authors.lastname: Mataki
authors.forename: Kousei
authors.initials: K
authors.lastname: Maemura
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shinchi
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D018572:Disease-Free Survival; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods / Q000401:mortality; D006801:Humans; D007150:Immunohistochemistry; D007564:Japan; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult