Combined resection with radiofrequency ablation for bilobar hepatocellular carcinoma: a single-center experience.
BACKGROUND
Bilobar hepatocellular carcinoma (HCC) is not rare and curative resection often cannot be achieved. However, the long-term results of nonsurgical treatments remain unsatisfactory. This study investigates the safety, efficacy, and long-term outcome of hepatic resection (HR) and resection combined with radiofrequency ablation (RFA) in treating patients with bilobar HCC.


METHODS
A retrospective study of 364 patients with bilobar HCC was carried out. Among them, 89 received HR, 114 received resection combined with RFA, and 161 received transarterial chemoembolization (TACE). The clinicopathologic parameters, surgical results, long-term outcomes, and prognostic factors were analyzed.


RESULTS
The median follow-up time was 28 mo (range, 3-84 mo). The 1-, 3-, 5-y overall survival rates were better after HR and resection combined with RFA than those of patients after TACE, that is, 78.9%, 49.4%, and 34.4%; 70.7%, 40.7%, and 22.3%; and 47.2%, 17.4%, and 8.6%, respectively (P < 0.001). Overall survival and recurrence-free survival rates were comparable between the two surgical groups. Child-Pugh stage, liver cirrhosis, and tumor number were identified as significant prognostic factors for overall survival by using the multivariate Cox model.


CONCLUSIONS
HR combined with RFA provided a chance for cure to patients with bilobar HCC who were traditionally deemed unresectable and yielded better long-term outcomes than TACE in a subset of patients. With preserved liver function, patients can receive aggressive treatment and survival could be prolonged.
Department of Liver Surgery and Liver Transplantation Centre, West China Hospital of Sichuan University, Chengdu, China.
Tao
T
Zhang
Department of Liver Surgery and Liver Transplantation Centre, West China Hospital of Sichuan University, Chengdu, China. Electronic address: zhangtaomd629@gmail.com.
Yong
Y
Zeng
Department of Liver Surgery and Liver Transplantation Centre, West China Hospital of Sichuan University, Chengdu, China.
Jiwei
J
Huang
Department of Liver Surgery and Liver Transplantation Centre, West China Hospital of Sichuan University, Chengdu, China.
Mingheng
M
Liao
Department of Liver Surgery and Liver Transplantation Centre, West China Hospital of Sichuan University, Chengdu, China.
Hong
H
Wu
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies
Hepatic resection; Hepatocellular carcinoma; Long-term outcome; Radiofrequency ablation