title: Liver resection versus radiofrequency ablation in the treatment of cirrhotic patients with hepatocellular carcinoma.
abstract: BACKGROUND
  Hepatocellular carcinoma is the most common type of primary liver tumor and its incidence is increasing worldwide. The study aimed to compare patients subjected to liver resection or radiofrequency ablation.
  
  
  METHODS
  One hundred and forty cirrhotic patients in stage A or B of Child-Pugh with single nodular or multinodular hepatocellular carcinoma were included in this retrospective study. Among them, 87 underwent surgical resection, and 53 underwent percutaneous radiofrequency ablation. Patient characteristics, survival, and recurrence-free survival were analyzed.
  
  
  RESULTS
  Recurrence-free survival was longer in the resection group in comparison to the radiofrequency group with a median recurrence-free time of 36 versus 26 months, respectively (P=0.01, HR=1.52, 95% CI: 1.05-2.25). In the resection group, median survival was 46 months, with the 1-, 3- and 5-year survival rates of 89.7%, 72.4% and 40.2%. In the radiofrequency group, median survival was 32 months, with the 1-, 3- and 5-year survival rates of 83.0%, 43.4% and 22.6% (P<0.01).
  
  
  CONCLUSIONS
  Surgical resection improves the overall survival and recurrence-free survival in comparison with radiofrequency ablation. New evidences are needed to define the real role of the percutaneous technique as an alternative to surgery.
authors.affiliation: Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy. djdesi85@hotmail.it
authors.forename: Amilcare
authors.initials: A
authors.lastname: Parisi
authors.forename: Jacopo
authors.initials: J
authors.lastname: Desiderio
authors.forename: Stefano
authors.initials: S
authors.lastname: Trastulli
authors.forename: Elisa
authors.initials: E
authors.lastname: Castellani
authors.forename: Rosario
authors.initials: R
authors.lastname: Pasquale
authors.forename: Roberto
authors.initials: R
authors.lastname: Cirocchi
authors.forename: Carlo
authors.initials: C
authors.lastname: Boselli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Noya
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications* / Q000401:mortality; D008113:Liver Neoplasms / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome