Juxian Song1, Yu Wang1, Kuansheng Ma1, Shuguo Zheng1, Ping Bie1, Feng Xia1, Xiaowu Li1, Jianwei Li1, Xiaojun Wang1, Jian Chen2. 1. Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Gaotanyan Main Street 29, Shapingba District, Chongqing, 400038, China. 2. Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Gaotanyan Main Street 29, Shapingba District, Chongqing, 400038, China. cjcrj@yahoo.com.
Abstract
BACKGROUND: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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: Maurizio Pompili; Antonio Saviano; Nicoletta de Matthaeis; Alessandro Cucchetti; Francesco Ardito; Bruno Federico; Franco Brunello; Antonio D Pinna; Antonio Giorgio; Stefano M Giulini; Ilario De Sio; Guido Torzilli; Fabio Fornari; Lorenzo Capussotti; Alfredo Guglielmi; Fabio Piscaglia; Luca Aldrighetti; Eugenio Caturelli; Fulvio Calise; Gennaro Nuzzo; Gian Ludovico Rapaccini; Felice Giuliante Journal: J Hepatol Date: 2013-03-22 Impact factor: 25.083
Authors: Jacques Ferlay; Isabelle Soerjomataram; Rajesh Dikshit; Sultan Eser; Colin Mathers; Marise Rebelo; Donald Maxwell Parkin; David Forman; Freddie Bray Journal: Int J Cancer Date: 2014-10-09 Impact factor: 7.396
Authors: Giovanni Battista Levi Sandri; Edoardo de Werra; Gianluca Mascianà; Marco Colasanti; Roberto Santoro; Vito D'Andrea; Giuseppe Maria Ettorre Journal: Hepatobiliary Surg Nutr Date: 2016-12 Impact factor: 7.293
Authors: Tan To Cheung; Ho-Seong Han; Wong Hoi She; Kuo-Hsin Chen; Pierce K H Chow; Boon Koon Yoong; Kit Fai Lee; Shoji Kubo; Chung Ngai Tang; Go Wakabayashi Journal: Liver Cancer Date: 2017-12-09 Impact factor: 11.740