A comparison between surgical resection and radiofrequency ablation in the treatment of hepatocellular carcinoma

Eun Kyu Park, Hee Joon Kim, Choong Young Kim, Young Hoe Hur, Yang Seok Koh, Jung Chul Kim, Hyun Jong Kim, Jin Woong Kim, Chol Kyoon Cho, Eun Kyu Park, Hee Joon Kim, Choong Young Kim, Young Hoe Hur, Yang Seok Koh, Jung Chul Kim, Hyun Jong Kim, Jin Woong Kim, Chol Kyoon Cho

Abstract

Purpose: The aim of this study was to compare the therapeutic effects of radiofrequency ablation (RFA) and hepatic resection (HR) with regards to procedural morbidity, mortality, overall survival (OS) and disease-free survival (DFS) rates in hepatocellular carcinoma (HCC) patients.

Methods: Retrospective studies were performed based on the medical records of 129 patients who underwent curative HR, and 57 who patients received RFA for HCC, between 2005 and 2009. The inclusion criteria of HCC were the presence of three or fewer nodules 3 cm or less in diameter or a single nodule of 5 cm or less.

Results: The 1-, 3- and 5-year OS rates in the HR group were 91.3%, 78.8%, and 64.9%, compared to 94.4%, 74.0%, and 74.0% in the RFA group, with no significant difference between the two groups (P = 0.725). The estimated 1- and 3-year DFS rates were 70.0% and 53.0% in the HR group and 65.2% and 24.7% in the RFA group, respectively. The DFS rates of HR group were significantly higher than RFA group (P = 0.015). Multivariate analysis identified that recurrence (P = 0.036) and portal hypertension (P = 0.036) were associated with OS and that portal hypertension (P = 0.048) and increased serum α-FP (P = 0.008) were the factors significantly associated with DFS.

Conclusion: HCC within Milan criteria should consider hepatectomy as the primary treatment if the patient's liver function and general conditions are good enough to undergo surgical operation. But in that RFA revealed similar overall survival to HR, RFA can be an alternative therapy for patients who are eligible for surgical resection.

Keywords: Catheter ablation; Hepatectomy; Hepatocellular carcinoma; Survival rate.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Overall (A) and disease-free survival (B) of all patients in the two treatment groups. (A) The overall survival were not significantly different (P = 0.725), in the two treatment groups. (B) But disease-free survival was significantly higher in hepatic resection (HR) group (P = 0.015). RFA, radiofrequency ablation.
Fig. 2
Fig. 2
Disease-free survival of patients with hepatocellular carcinoma (HCC ≤ 3 cm (A) and 3 cm

Fig. 3

Disease-free survival of patients with…

Fig. 3

Disease-free survival of patients with α-FP below 20 ng/mL and absence of portal…

Fig. 3
Disease-free survival of patients with α-FP below 20 ng/mL and absence of portal hypertension in the two treatment groups: Disease-free survival was higher in hepatic resection (HR) group but the difference did not reach statistical significance (P = 0.228). RFA, radiofrequency ablation.
Fig. 3
Fig. 3
Disease-free survival of patients with α-FP below 20 ng/mL and absence of portal hypertension in the two treatment groups: Disease-free survival was higher in hepatic resection (HR) group but the difference did not reach statistical significance (P = 0.228). RFA, radiofrequency ablation.

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