BACKGROUND: Whether percutaneous radiofrequency ablation (PRFA) is as effective as repeat hepatectomy for recurrent small hepatocellular carcinoma (HCC) in the long-term remains unknown. METHODS: We included 110 patients into this study. Each patient had fewer than three recurrent HCCs, with the largest tumor less than 5 cm in diameter. Sixty-six patients with 88 tumors were treated by PRFA and 44 patients with 55 tumors were treated by repeat hepatectomy. RESULTS: The 1-, 2-, 3-, 4-, and 5-year overall survival rates after repeat hepatectomy and PRFA were 78.6%, 56.8%, 44.5%, 30.7%, and 27.6%, and 76.6%, 48.6%, 48.6%, 39.9%, and 39.9%, respectively (P = 0.79). The 1-, 2-, 3-, 4-, and 5-year overall survival rates after the initial hepatectomy for the two groups were 95.4%, 79.1%, 65.0%, 50.4%, and 42.9%, and 98.5%, 85.0%, 70.8%, 58.7%, and 55.6%, respectively, (P = 0.18). Subgroup analyses showed that there was no significant difference between the overall survivals of the two groups of patients when the interval of tumor recurrence from the initial hepatectomy was <or=1 year (P = 0.74) or >1 year (P = 0.69), and for recurrent tumor <or=3 cm (P = 0.62) or >3 cm (P = 0.57). Major complications happened significantly more often after repeat hepatectomy than PRFA (30 of 44 versus 2 of 66, P < 0.05). The interval of recurrence from the initial hepatectomy, the diameter of the recurrent tumor and the serum albumin level were significant prognostic factors for overall survival. CONCLUSION: PRFA was as effective as repeat hepatectomy in the treatment of recurrent small HCC. PRFA had the advantage over repeat hepatectomy in being less invasive.
BACKGROUND: Whether percutaneous radiofrequency ablation (PRFA) is as effective as repeat hepatectomy for recurrent small hepatocellular carcinoma (HCC) in the long-term remains unknown. METHODS: We included 110 patients into this study. Each patient had fewer than three recurrent HCCs, with the largest tumor less than 5 cm in diameter. Sixty-six patients with 88 tumors were treated by PRFA and 44 patients with 55 tumors were treated by repeat hepatectomy. RESULTS: The 1-, 2-, 3-, 4-, and 5-year overall survival rates after repeat hepatectomy and PRFA were 78.6%, 56.8%, 44.5%, 30.7%, and 27.6%, and 76.6%, 48.6%, 48.6%, 39.9%, and 39.9%, respectively (P = 0.79). The 1-, 2-, 3-, 4-, and 5-year overall survival rates after the initial hepatectomy for the two groups were 95.4%, 79.1%, 65.0%, 50.4%, and 42.9%, and 98.5%, 85.0%, 70.8%, 58.7%, and 55.6%, respectively, (P = 0.18). Subgroup analyses showed that there was no significant difference between the overall survivals of the two groups of patients when the interval of tumor recurrence from the initial hepatectomy was <or=1 year (P = 0.74) or >1 year (P = 0.69), and for recurrent tumor <or=3 cm (P = 0.62) or >3 cm (P = 0.57). Major complications happened significantly more often after repeat hepatectomy than PRFA (30 of 44 versus 2 of 66, P < 0.05). The interval of recurrence from the initial hepatectomy, the diameter of the recurrent tumor and the serum albumin level were significant prognostic factors for overall survival. CONCLUSION: PRFA was as effective as repeat hepatectomy in the treatment of recurrent small HCC. PRFA had the advantage over repeat hepatectomy in being less invasive.
Authors: Michael J Ryan; Jonathon Willatt; Bill S Majdalany; Ania Z Kielar; Suzanne Chong; Julie A Ruma; Amit Pandya Journal: World J Hepatol Date: 2016-01-28
Authors: Junichi Tokuda; William Plishker; Meysam Torabi; Olutayo I Olubiyi; George Zaki; Servet Tatli; Stuart G Silverman; Raj Shekher; Nobuhiko Hata Journal: Acad Radiol Date: 2015-03-14 Impact factor: 3.173
Authors: Leonidas G Koniaris; David M Levi; Felipe E Pedroso; Dido Franceschi; Andreas G Tzakis; Juan A Santamaria-Barria; Jennifer Tang; Marissa Anderson; Subhasis Misra; Naveenraj L Solomon; Xiaoling Jin; Peter J DiPasco; Margaret M Byrne; Teresa A Zimmers Journal: Ann Surg Date: 2011-09 Impact factor: 12.969