title: Radiofrequency ablation for single hepatocellular carcinoma 3 cm or less as first-line treatment.
abstract: OBJECTIVE
  To evaluate long-term outcomes of radiofrequency (RF) ablation as first-line therapy for single hepatocellular carcinoma (HCC) ≤ 3 cm and to determine survival and prognostic factors.
  
  
  METHODS
  We included all 184 patients who underwent RF ablation as a first-line treatment for single HCC ≤ 3 cm between April 2005 and December 2013. According to the criteria of Livraghi, the 184 patients were divided into two groups: those suitable for surgical resection (84 cases) and those unsuitable for surgical resection (100 cases). The primary endpoints were the overall survival (OS) rate and safety; the secondary endpoints were primary technique effectiveness and recurrence rate.
  
  
  RESULTS
  There were 19 (10.3%) cases of ablation related minor complications. The complete tumor ablation rate after one RF session was 97.8% (180/184). The rate of local tumor progression, extrahepatic metastases and intrahepatic distant recurrence were 4.9% (9/184), 9.8% (18/184) and 37.5% (69/184), respectively. In the 184 patients, the 1-, 3-, and 5-year OS rates were 99.5%, 81.0%, and 62.5%, respectively. The 1-, 3-, and 5-year OS rates were 100%, 86.9%, and 71.4%, respectively, in those suitable for surgical resection and 99.0%, 76.0%, and 55.0%, respectively, in those unsuitable for surgical resection (P = 0.021). On univariate and multivariate analyses, poorer OS was associated with Child-Pugh B class and portal hypertension (P < 0.05).
  
  
  CONCLUSIONS
  RF ablation is a safe and effective treatment for single HCC ≤ 3 cm. The OS rate of patients suitable for surgical resection was similar to those reported in surgical series.
authors.affiliation: Jun Gao, Shao-Hong Wang, Xue-Mei Ding, Wen-Bing Sun, Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Gao
authors.affiliation: Jun Gao, Shao-Hong Wang, Xue-Mei Ding, Wen-Bing Sun, Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China.
authors.forename: Shao-Hong
authors.initials: SH
authors.lastname: Wang
authors.affiliation: Jun Gao, Shao-Hong Wang, Xue-Mei Ding, Wen-Bing Sun, Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China.
authors.forename: Xue-Mei
authors.initials: XM
authors.lastname: Ding
authors.affiliation: Jun Gao, Shao-Hong Wang, Xue-Mei Ding, Wen-Bing Sun, Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China.
authors.forename: Wen-Bing
authors.initials: WB
authors.lastname: Sun
authors.affiliation: Jun Gao, Shao-Hong Wang, Xue-Mei Ding, Wen-Bing Sun, Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China.
authors.forename: Xiao-Long
authors.initials: XL
authors.lastname: Li
authors.affiliation: Jun Gao, Shao-Hong Wang, Xue-Mei Ding, Wen-Bing Sun, Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China.
authors.forename: Zong-Hai
authors.initials: ZH
authors.lastname: Xin
authors.affiliation: Jun Gao, Shao-Hong Wang, Xue-Mei Ding, Wen-Bing Sun, Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China.
authors.forename: Chun-Min
authors.initials: CM
authors.lastname: Ning
authors.affiliation: Jun Gao, Shao-Hong Wang, Xue-Mei Ding, Wen-Bing Sun, Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China.
authors.forename: Shi-Gang
authors.initials: SG
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D002681:China; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D016017:Odds Ratio; D018579:Patient Selection; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Hepatocellular carcinoma; Radiofrequency ablation; Safety; Survival; Therapeutic efficacy