title: Laparoscopic hepatectomy versus radiofrequency ablation for minimally invasive treatment of single, small hepatocellular carcinomas.
abstract: There is currently no clear consensus on the relative suitabilities of laparoscopic hepatectomy (LH) and radiofrequency ablation (RFA) as minimally invasive treatment for small hepatocellular carcinoma (HCC).
  
  
  
  In this retrospective study, we enrolled 156 patients with a single, small HCC with nodular diameters <4 cm and compared recurrence-free survival (RFS) and overall survival (OS) between patients treated with LH and control patients treated with RFA (n = 78 each). The groups were selected according to predefined criteria and matched in terms of their baseline clinical characteristics.
  
  
  
  During a median follow-up of 31.2 months, the 1-, 2-, and 3-year OS rates in the LH group were 96.2, 91.3, and 84.1 %, respectively, compared with 96.2, 82.6, and 78.8 % in the RFA group. The corresponding RFS rates were 82.1, 71.5, and 60.0 % in the LH group and 65.4, 47.7, and 37.6 % in the RFA group. Combined RFS rates were significantly higher in the LH groups (P = 0.006), but there was no significant difference in OS rates (P = 0.510). The incidence of postoperative complications was significantly lower in the RFA group (28.2 vs. 10.3 %, P = 0.004), and operation duration, intraoperative blood loss and blood transfusion, use of total parenteral nutrition, and length of stay as indicators of minimal invasiveness were also significantly better in the RFA group.
  
  
  
  There was no difference between LH and RFA in terms of OS in patients with a single, small HCC. However, RFA was less invasive than the LH, but LH was associated with increased RFS.
authors.affiliation: Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Gaotanyan Main Street 29, Shapingba District, Chongqing, 400038, China.
authors.forename: Juxian
authors.initials: J
authors.lastname: Song
authors.affiliation: Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Gaotanyan Main Street 29, Shapingba District, Chongqing, 400038, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Gaotanyan Main Street 29, Shapingba District, Chongqing, 400038, China.
authors.forename: Kuansheng
authors.initials: K
authors.lastname: Ma
authors.affiliation: Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Gaotanyan Main Street 29, Shapingba District, Chongqing, 400038, China.
authors.forename: Shuguo
authors.initials: S
authors.lastname: Zheng
authors.affiliation: Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Gaotanyan Main Street 29, Shapingba District, Chongqing, 400038, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Bie
authors.affiliation: Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Gaotanyan Main Street 29, Shapingba District, Chongqing, 400038, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Xia
authors.affiliation: Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Gaotanyan Main Street 29, Shapingba District, Chongqing, 400038, China.
authors.forename: Xiaowu
authors.initials: X
authors.lastname: Li
authors.affiliation: Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Gaotanyan Main Street 29, Shapingba District, Chongqing, 400038, China.
authors.forename: Jianwei
authors.initials: J
authors.lastname: Li
authors.affiliation: Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Gaotanyan Main Street 29, Shapingba District, Chongqing, 400038, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Wang
authors.affiliation: Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Gaotanyan Main Street 29, Shapingba District, Chongqing, 400038, China. cjcrj@yahoo.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications; D012189:Retrospective Studies
keywords: Hepatocellular carcinoma; Laparoscopic hepatectomy; Radiofrequency ablation