title: Single hepatocellular carcinoma ≤ 3 cm in left lateral segment: liver resection or radiofrequency ablation?
abstract: OBJECTIVE
  To evaluate the long-term results of radiofrequency ablation (RFA) compared to left lateral sectionectomy (LLS) in patients with Child-Pugh class A disease for the treatment of single and small hepatocellular carcinoma (HCC) in the left lateral segments.
  
  
  METHODS
  We retrospectively reviewed the data of 133 patients with single HCC (≤ 3 cm) in their left lateral segments who underwent curative LLS (n = 66) or RFA (n = 67) between 2006 and 2010.
  
  
  RESULTS
  The median follow-up period was 33.5 mo in the LLS group and 29 mo in the RFA group (P = 0.060). Most patients had hepatitis B virus-related HCC. The hospital stay was longer in the LLS group than in the RFA group (8 d vs 2 d, P < 0.001). The 1-, 2-, and 3-year disease-free survival and overall survival rates were 80.0%, 68.2%, and 60.0%, and 95.4%, 92.3%, and 92.3%, respectively, for the LLS group; and 80.8%, 59.9%, and 39.6%, and 98.2%, 92.0%, and 74.4%, respectively, for the RFA group. The disease-free survival curve and overall survival curve were higher in the LLS group than in the RFA group (P = 0.012 and P = 0.013, respectively). Increased PIVKA-II levels and small tumor size were associated with HCC recurrence in multivariate analysis.
  
  
  CONCLUSIONS
  Liver resection is suitable for single HCC ≤ 3 cm in the left lateral segments.
authors.affiliation: Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Jae Berm Park, Sung Joo Kim, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
authors.forename: Jong Man
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Jae Berm Park, Sung Joo Kim, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
authors.forename: Tae Wook
authors.initials: TW
authors.lastname: Kang
authors.affiliation: Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Jae Berm Park, Sung Joo Kim, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
authors.forename: Choon Hyuck David
authors.initials: CH
authors.lastname: Kwon
authors.affiliation: Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Jae Berm Park, Sung Joo Kim, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Joh
authors.affiliation: Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Jae Berm Park, Sung Joo Kim, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
authors.forename: Justin Sangwook
authors.initials: JS
authors.lastname: Ko
authors.affiliation: Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Jae Berm Park, Sung Joo Kim, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
authors.forename: Jae Berm
authors.initials: JB
authors.lastname: Park
authors.affiliation: Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Jae Berm Park, Sung Joo Kim, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
authors.forename: Hyunchul
authors.initials: H
authors.lastname: Rhim
authors.affiliation: Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Jae Berm Park, Sung Joo Kim, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
authors.forename: Joon Hyeok
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Jae Berm Park, Sung Joo Kim, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
authors.forename: Sung Joo
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Jae Berm Park, Sung Joo Kim, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Paik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery* / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006760:Hospitalization; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Left lateral segment; Liver resection; Radiofrequency ablation; Small hepatocellular carcinoma; Survival; Tumor recurrence
references.citation: Transplantation. 2002 Dec 27;74(12):1746-51
references.pmid: 12499891
references.citation: J Hepatol. 2012 Oct;57(4):794-802
references.pmid: 22634125
references.citation: Clin Gastroenterol Hepatol. 2012 Jan;10(1):16-21
references.pmid: 21699816
references.citation: Jpn J Clin Oncol. 2007 Sep;37(9):658-72
references.pmid: 17766723
references.citation: Korean J Hepatol. 2004 Jun;10(2):88-98
references.pmid: 15218342
references.citation: Eur J Radiol. 2010 Aug;75(2):253-8
references.pmid: 19427152
references.citation: Surg Endosc. 2011 May;25(5):1603-10
references.pmid: 21136115
references.citation: Oncology. 2010 Jul;78 Suppl 1:113-24
references.pmid: 20616593
references.citation: World J Gastroenterol. 2006 Jan 28;12(4):546-52
references.pmid: 16489666
references.citation: Ann Surg. 2011 Mar;253(3):453-69
references.pmid: 21263310
references.citation: Ann Surg Oncol. 2008 May;15(5):1375-82
references.pmid: 18324443
references.citation: Ann Surg. 2005 Aug;242(2):252-9
references.pmid: 16041216
references.citation: J Gastroenterol Hepatol. 2012 Jan;27(1):51-8
references.pmid: 22004366
references.citation: Hepatology. 2000 Dec;32(6):1224-9
references.pmid: 11093728
references.citation: Radiology. 2012 Mar;262(3):1022-33
references.pmid: 22357902
references.citation: J Hepatol. 2008;48 Suppl 1:S20-37
references.pmid: 18304676
references.citation: World J Surg Oncol. 2012 Aug 16;10:163
references.pmid: 22897815
references.citation: Cancer. 2005 Jan 15;103(2):299-306
references.pmid: 15578688
references.citation: Ann Surg. 2006 Mar;243(3):321-8
references.pmid: 16495695
references.citation: Hepatology. 2010 Apr;51(4):1116-8
references.pmid: 20373366
references.citation: BMC Gastroenterol. 2010 Jul 09;10:78
references.pmid: 20618937
references.citation: Ann Surg. 2010 Dec;252(6):903-12
references.pmid: 21107100
references.citation: Eur Radiol. 2013 Jan;23(1):190-7
references.pmid: 23085860
references.citation: Cancer. 2005 Mar 15;103(6):1201-9
references.pmid: 15690326
references.citation: Hepatology. 2005 Nov;42(5):1208-36
references.pmid: 16250051
references.citation: World J Surg Oncol. 2013 Apr 23;11:92
references.pmid: 23618082
references.citation: Hepatology. 2008 Jan;47(1):82-9
references.pmid: 18008357