title: Radiofrequency ablation versus surgical resection for hepatocellular carcinoma within the Milan criteria: A study of 281 Western patients.
abstract: OBJECTIVE
  The aim of this study was to compare survival between radiofrequency ablation (RFA) and surgical resection (SR) in patients with hepatocellular carcinoma (HCC) within Milan criteria.
  
  
  METHODS
  From January 2004 to December 2013 we consecutively and retrospectively included all patients with first occurrence of HCC within Milan criteria receiving SR or RFA as first-line treatment. The cumulative overall survival (OS) and disease-free survival (DFS) were compared after inverse probability weighting (including confounding factor).
  
  
  RESULTS
  A total of 281 patients (RFA 178, SR 103) were enrolled. In multivariate Cox regression RFA and SR were not independent predictors of survival or recurrence. The respective weighted 5 years OS and DFS for patients with propensity scores between 0.1-0.9 in the SR and RFA groups were 54-33% and 60-16.9%, P = 0.695 and P = 0.426, respectively. Local tumour progression rate did not differ according to treatment (P = 0.523). Major complication rate was higher in the SR group, P = 0.001. Hospitalisation duration was lower in the RFA group (mean 2.19 days, range 2-7) than in the SR group (mean 10.2 days, range 3-30), P < 0.001.
  
  
  CONCLUSIONS
  This large Western study has shown that OS and DFS did not differ after RFA (using mainly multipolar devices) and SR, for HCC within the Milan criteria in a European population, with a shorter hospitalisation time and a lower complication rate for RFA.
authors.affiliation: a Department of Diagnostic and Interventional Imaging , Hôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux .
authors.forename: Arnaud
authors.initials: A
authors.lastname: Hocquelet
authors.affiliation: a Department of Diagnostic and Interventional Imaging , Hôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux .
authors.forename: Pierre
authors.initials: P
authors.lastname: Balageas
authors.affiliation: b Department of Visceral Surgery , Hôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux .
authors.forename: Christophe
authors.initials: C
authors.lastname: Laurent
authors.affiliation: c Department of Hepato-Gastroenterology and Digestive Oncology , Hôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux , Bordeaux , and.
authors.forename: Jean-Frédéric
authors.initials: JF
authors.lastname: Blanc
authors.affiliation: a Department of Diagnostic and Interventional Imaging , Hôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux .
authors.forename: Nora
authors.initials: N
authors.lastname: Frulio
authors.affiliation: a Department of Diagnostic and Interventional Imaging , Hôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux .
authors.forename: Cécile
authors.initials: C
authors.lastname: Salut
authors.affiliation: d Department of Diagnostic and Interventional Imaging , Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux , Pessac , France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Cassinotto
authors.affiliation: b Department of Visceral Surgery , Hôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux .
authors.forename: Jean
authors.initials: J
authors.lastname: Saric
authors.affiliation: c Department of Hepato-Gastroenterology and Digestive Oncology , Hôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux , Bordeaux , and.
authors.forename: Laurent
authors.initials: L
authors.lastname: Possenti
authors.affiliation: c Department of Hepato-Gastroenterology and Digestive Oncology , Hôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux , Bordeaux , and.
authors.forename: Pierre-Henri
authors.initials: PH
authors.lastname: Bernard
authors.affiliation: d Department of Diagnostic and Interventional Imaging , Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux , Pessac , France.
authors.forename: Michel
authors.initials: M
authors.lastname: Montaudon
authors.affiliation: a Department of Diagnostic and Interventional Imaging , Hôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux .
authors.forename: Hervé
authors.initials: H
authors.lastname: Trillaud
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011336:Probability; D061208:Pulsed Radiofrequency Treatment; D012189:Retrospective Studies
keywords: Barcelona Clinic Liver Cancer (BCLC) stage; Milan criteria; hepatocellular carcinoma; radiofrequency ablation; surgical resection