Hyo-Jae Lee1, Jin Woong Kim2, Young Hoe Hur3, Sung Bum Cho4, Byung Chan Lee1, Byung Kook Lee5, Eu Chang Hwang6, Yong Soo Cho7, Hyun Ju Seon7. 1. Department of Radiology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Republic of Korea. 2. Department of Radiology, Chosun University Hospital and Chosun University College of Medicine, Gwangju, Republic of Korea. Electronic address: jw4249@hanmail.net. 3. Department of Hepato-Pancreato-Biliary Surgery, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Republic of Korea. 4. Department of Internal Medicine, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Republic of Korea. 5. Department of Emergency Medicine, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Republic of Korea. 6. Department of Urology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Republic of Korea. 7. Department of Radiology, Chosun University Hospital and Chosun University College of Medicine, Gwangju, Republic of Korea.
Abstract
PURPOSE: To retrospectively compare long-term outcomes of conventional chemoembolization plus radiofrequency (RF) ablation vs those of surgical resection in patients with a single 3-5-cm hepatocellular carcinoma (HCC). MATERIALS AND METHODS: From January 2008 to December 2017, 139 of 623 patients who underwent surgical resection and 60 of 186 patients who underwent chemoembolization/RF ablation in a single center were compared with respect to local tumor progression (LTP), intrahepatic distant recurrence (IDR), disease-free survival (DFS), overall survival (OS), major complications, and hospital stay before and after propensity-score matching. RESULTS: Mean follow-up periods were similar in the chemoembolization/RF ablation and surgical resection groups (41.9 mo vs 48.4 mo). Three (5%) and 17 (28.3%) patients in the chemoembolization/RF ablation group and 12 (8.6%) and 57 (41.0%) patients in the surgical resection group showed LTP and IDR (P = .366 and P =.114, respectively). At 1, 3, and 5 years, respective DFS rates were 88.1%, 65.3%, and 49.0% for chemoembolization/RF ablation and 84.2%, 58.2%, and 46.5% for surgical resection (P = .294). Moreover, respective OS rates were 95.0%, 73.5%, and 54.0% for chemoembolization/RF ablation and 97.1%, 87.4%, and 75.0% for surgical resection (P = .055). After matching (n = 52), therapeutic outcomes remained similar (P = .370, P = .110, P = .230, and P = .760, respectively). Surgical resection was associated with higher complication rates (P = .015) and longer hospital stays (8.4 d ± 3.7 vs 16.9 d ± 7.0; P < .001). CONCLUSIONS: Conventional chemoembolization combined with RF ablation may be feasible for single 3-5-cm HCCs, with comparable therapeutic outcomes vs surgical resection and shorter hospital stays.
PURPOSE: To retrospectively compare long-term outcomes of conventional chemoembolization plus radiofrequency (RF) ablation vs those of surgical resection in patients with a single 3-5-cm hepatocellular carcinoma (HCC). MATERIALS AND METHODS: From January 2008 to December 2017, 139 of 623 patients who underwent surgical resection and 60 of 186 patients who underwent chemoembolization/RF ablation in a single center were compared with respect to local tumor progression (LTP), intrahepatic distant recurrence (IDR), disease-free survival (DFS), overall survival (OS), major complications, and hospital stay before and after propensity-score matching. RESULTS: Mean follow-up periods were similar in the chemoembolization/RF ablation and surgical resection groups (41.9 mo vs 48.4 mo). Three (5%) and 17 (28.3%) patients in the chemoembolization/RF ablation group and 12 (8.6%) and 57 (41.0%) patients in the surgical resection group showed LTP and IDR (P = .366 and P =.114, respectively). At 1, 3, and 5 years, respective DFS rates were 88.1%, 65.3%, and 49.0% for chemoembolization/RF ablation and 84.2%, 58.2%, and 46.5% for surgical resection (P = .294). Moreover, respective OS rates were 95.0%, 73.5%, and 54.0% for chemoembolization/RF ablation and 97.1%, 87.4%, and 75.0% for surgical resection (P = .055). After matching (n = 52), therapeutic outcomes remained similar (P = .370, P = .110, P = .230, and P = .760, respectively). Surgical resection was associated with higher complication rates (P = .015) and longer hospital stays (8.4 d ± 3.7 vs 16.9 d ± 7.0; P < .001). CONCLUSIONS: Conventional chemoembolization combined with RF ablation may be feasible for single 3-5-cm HCCs, with comparable therapeutic outcomes vs surgical resection and shorter hospital stays.