title: Repeated Hepatic Resection versus Radiofrequency Ablation for Recurrent Hepatocellular Carcinoma after Hepatic Resection: A Propensity Score Matching Study.
abstract: OBJECTIVE
  To compare the long-term outcomes of repeated hepatic resection and radiofrequency (RF) ablation for recurrent hepatocellular carcinoma (HCC) by using propensity score matching.
  
  
  METHODS
  This retrospective study was approved by the institutional review board, and the requirement to obtain informed consent was waived. Thirty-nine patients who underwent repeated hepatic resection and 178 who underwent RF ablation for recurrent HCC (mean tumor size ± standard deviation, 1.8 cm ± 0.7) between November 1994 and December 2012 were included in the study. Patients ranged in age from 24 to 85 years (mean, 54.9 years). Men ranged in age from 25 to 85 years (mean, 54.8 years), and women ranged in age from 24 to 76 years (mean, 55.4 years). A 1:2 repeated hepatic resection group-RF ablation group matching was done by using propensity score matching. The overall survival (OS) and disease-free survival (DFS) were compared before and after propensity score matching. Complications were assessed.
  
  
  RESULTS
  Before matching, OS rates at 1, 3, 5, and 8 years were 88.8%, 88.8%, 83.9%, and 56.3%, respectively, with repeated hepatic resection and 98.9%, 82.5%, 71.0%, and 58.3% for RF ablation. DFS rates at 1, 3, and 5 years were 66.1%, 48.5%, and 43.1% for repeated hepatic resection and 70.1%, 40.8%, and 30.0% for RF ablation. After matching, the OS rates at 1, 3, 5, and 8 years were 98.7%, 85.7%, 72.1%, and 68.6%, respectively, and the DFS rates at 1, 3, and 5 years were 71.8%, 45.1%, and 39.4% in the RF ablation group (n = 78). Neither the OS nor DFS rate was significantly different between the two groups before matching (P = .686 and P = .461) and after matching (P = .834 and P = .960). The postoperative mortality rate was 2.6% in the repeated hepatic resection group and 0% in the RF ablation group.
  
  
  CONCLUSIONS
  The long-term OS and DFS were not significantly different between repeated hepatic resection and RF ablation for patients with recurrent HCC after hepatic resection.
authors.affiliation: From the Department of Radiology and Center for Imaging Science (K.D.S., H.K.L., H.R., M.W.L., Y.S.K., W.J.L.), Department of Medicine (Y.H.P., G.Y.G.), and Department of Surgery (J.M.K., C.H.D.K., J.W.J.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul 135-710, Republic of Korea.
authors.forename: Kyoung Doo
authors.initials: KD
authors.lastname: Song
authors.forename: Hyo Keun
authors.initials: HK
authors.lastname: Lim
authors.forename: Hyunchul
authors.initials: H
authors.lastname: Rhim
authors.forename: Min Woo
authors.initials: MW
authors.lastname: Lee
authors.forename: Young-Sun
authors.initials: YS
authors.lastname: Kim
authors.forename: Won Jae
authors.initials: WJ
authors.lastname: Lee
authors.forename: Yong Han
authors.initials: YH
authors.lastname: Paik
authors.forename: Geum-Youn
authors.initials: GY
authors.lastname: Gwak
authors.forename: Jong Man
authors.initials: JM
authors.lastname: Kim
authors.forename: Choon Hyuck David
authors.initials: CH
authors.lastname: Kwon
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Joh
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D057216:Propensity Score; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome