Arnaud Hocquelet1, Pierre Balageas1, Christophe Laurent2, Jean-Frédéric Blanc3, Nora Frulio1, Cécile Salut1, Christophe Cassinotto4, Jean Saric2, Laurent Possenti3, Pierre-Henri Bernard3, Michel Montaudon4, Hervé Trillaud1. 1. a Department of Diagnostic and Interventional Imaging , Hôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux . 2. b Department of Visceral Surgery , Hôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux . 3. c Department of Hepato-Gastroenterology and Digestive Oncology , Hôpital Saint-André, Centre Hospitalier Universitaire de Bordeaux , Bordeaux , and. 4. d Department of Diagnostic and Interventional Imaging , Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux , Pessac , France.
Abstract
OBJECTIVES: 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. CONCLUSION: 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.
OBJECTIVES: 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. CONCLUSION: 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.
Entities:
Keywords:
Barcelona Clinic Liver Cancer (BCLC) stage; Milan criteria; hepatocellular carcinoma; radiofrequency ablation; surgical resection
Authors: Bela Kis; Ghassan El-Haddad; Rahul A Sheth; Nainesh S Parikh; Suvranu Ganguli; Paul B Shyn; Junsung Choi; Karen T Brown Journal: Cancer Control Date: 2017 Jul-Sep Impact factor: 3.302