Yuqian Huang1, Qin Shen2, Harrison X Bai3, Jing Wu2, Cong Ma2, Quanliang Shang2, Steven J Hunt3, Giorgos Karakousis4, Paul J Zhang5, Zishu Zhang6. 1. Department of Neurology, The Second Xiangya Hospital, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan 410011, China. 2. Department of Radiology, The Second Xiangya Hospital, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan 410011, China. 3. Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. 4. Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. 5. Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. 6. Department of Radiology, The Second Xiangya Hospital, Central South University, No. 139 Middle Renmin Road, Changsha, Hunan 410011, China. Electronic address: zishuzhang@csu.edu.cn.
Abstract
PURPOSE: To compare survival outcome of radiofrequency (RF) ablation and surgical resection (SR) for treatment of hepatocellular carcinoma (HCC) ≤ 2 cm. MATERIALS AND METHODS: In this retrospective study, patients from the US National Cancer Database with HCC ≤ 2 cm received RF ablation or SR as sole treatment. Overall survival (OS) was compared using log-rank test, multivariable Cox proportional hazard regression, and propensity score matched analysis. RESULTS: Of 833 patients included, 620 received RF ablation and 213 received SR. The 1-, 3-, and 5-year OS rates were 90%, 64%, and 47% for RF ablation and 89%, 75%, and 62% for SR. On univariate analyses, patients who received SR had longer OS than patients who received RF ablation, but this did not achieve statistical significance (P = .113). On multivariate analyses, female sex (HR = 0.700; 95% CI, 0.501-0.979; P = .037), African American (HR = 0.611; 95% CI, 0.398-0.938; P = .024) and Asian ethnicity (HR = 0.427; 95% CI, 0.230-0.790; P = .007), and median income ≥ $48,000 (HR = 0.695; 95% CI, 0.518-0.932; P = .015) were associated with longer OS, whereas higher Model for End-stage Liver Disease (MELD) scores (HR = 1.023; 95% CI, 1.009-1.037; P = .001) were associated with shorter OS. After matching on age, sex, ethnicity, MELD score, and income, there was no significant difference in OS between the 2 treatment groups (log-rank P = .646). CONCLUSIONS: There was no significant difference in OS between RF ablation and SR in treatment of HCC measuring ≤ 2 cm.
PURPOSE: To compare survival outcome of radiofrequency (RF) ablation and surgical resection (SR) for treatment of hepatocellular carcinoma (HCC) ≤ 2 cm. MATERIALS AND METHODS: In this retrospective study, patients from the US National Cancer Database with HCC ≤ 2 cm received RF ablation or SR as sole treatment. Overall survival (OS) was compared using log-rank test, multivariable Cox proportional hazard regression, and propensity score matched analysis. RESULTS: Of 833 patients included, 620 received RF ablation and 213 received SR. The 1-, 3-, and 5-year OS rates were 90%, 64%, and 47% for RF ablation and 89%, 75%, and 62% for SR. On univariate analyses, patients who received SR had longer OS than patients who received RF ablation, but this did not achieve statistical significance (P = .113). On multivariate analyses, female sex (HR = 0.700; 95% CI, 0.501-0.979; P = .037), African American (HR = 0.611; 95% CI, 0.398-0.938; P = .024) and Asian ethnicity (HR = 0.427; 95% CI, 0.230-0.790; P = .007), and median income ≥ $48,000 (HR = 0.695; 95% CI, 0.518-0.932; P = .015) were associated with longer OS, whereas higher Model for End-stage Liver Disease (MELD) scores (HR = 1.023; 95% CI, 1.009-1.037; P = .001) were associated with shorter OS. After matching on age, sex, ethnicity, MELD score, and income, there was no significant difference in OS between the 2 treatment groups (log-rank P = .646). CONCLUSIONS: There was no significant difference in OS between RF ablation and SR in treatment of HCC measuring ≤ 2 cm.