title: Liver resection and radiofrequency ablation of very early hepatocellular carcinoma cases (single nodule <2 cm): a single-center study.
abstract: OBJECTIVE
  The aim of our study was to compare the short-term and long-term outcomes of resection and radiofrequency ablation (RFA) in cases of very early hepatocellular carcinoma (HCC) (tumors<2 cm in diameter).
  
  
  METHODS
  Between July 2003 and August 2008, 52 patients were diagnosed as very early HCC (≤2 cm), of whom 21 received a liver resection and 31 underwent RFA. We compared the baseline characteristics, the intraoperative data, and the recovery metrics between these two groups including postoperative complications and the 1-, 3-, and 5-year overall and tumor-free survival rates.
  
  
  RESULTS
  No statistically significant differences were observed in the baseline characteristics between very early HCC patients allocated to the liver resection group and those in the RFA group. The liver function in the liver resection group was better than that of the RFA group with respect to the Child score (P=0.004), but not the model for end-stage liver disease score (P=0.066). More tumor targets were located in the center of the liver (compared with the periphery) in the RFA group (P=0.003). The RFA patients showed much shorter operative times, less blood loss, and had shorter hospital stays than the resection group but had a much higher overall cost (all P=0.000). The 1-, 3-, and 5-year overall survival rates were 95.2, 85.7, and 81.0%, respectively, for the liver resection group, and 93.5, 90.3, and 80.6%, respectively, for the RFA group (P=0.976). The 1-, 3-, and 5-year tumor-free survival rates were 90.5, 81.0, and 76.2%, respectively, in the resection group and 90.3, 83.9, and 71.0%, respectively, in the RFA group (P=0.830).
  
  
  CONCLUSIONS
  With comparable short-term and long-term effects on overall survival and tumor recurrence rate and with a shorter operative time, less blood loss, and a shorter hospital stay, RFA should be considered as the first choice for the treatment for very early HCCs as it presents an efficacious and economic option.
authors.affiliation: Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Zhipeng
authors.initials: Z
authors.lastname: Zhou
authors.forename: Jianyong
authors.initials: J
authors.lastname: Lei
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.forename: Lunan
authors.initials: L
authors.lastname: Yan
authors.forename: Wentao
authors.initials: W
authors.lastname: Wang
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Wei
authors.forename: Kefei
authors.initials: K
authors.lastname: Cheng
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007432:Intraoperative Period; D007902:Length of Stay / Q000706:statistics & numerical data; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome