Charing Ching-Ning Chong1, Kit-Fai Lee2, Cheuk-Man Chu3, Anthony Wing-Hung Chan4, Simon Chun-Ho Yu3, Paul Bo-San Lai2. 1. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China, chongcn@surgery.cuhk.edu.hk. 2. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China. 3. Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China. 4. Department of Anatomical and Cellular Pathology, State Key Laboratory in Oncology in South China, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Abstract
BACKGROUND: The advantages of radiofrequency ablation (RFA) over hepatectomy as a treatment for early-stage hepatocellular carcinoma (HCC) include reduced morbidity and more rapid recovery. Although minimally invasive surgery provides similar benefits, few studies have compared the long-term oncological outcomes of these techniques. This study aimed to compare the outcomes of minimally invasive hepatectomy (MIH) and RFA. METHODS: Patients who underwent MIH or RFA for HCC between January 2005 and January 2015 were included in a propensity score matching analysis. Only patients who underwent minimally invasive procedures for small HCC were included. Baseline clinical and laboratory parameters were retrieved from the hospital database and analyzed. RESULTS: Two hundred and twenty-five patients underwent MIH or RFA for HCC during the study period. Propensity score matching yielded 59 patient-pairs. The complication rates did not differ statistically between the 2 groups (p = 0.309). However, MIH provided significantly better overall (p = 0.005) and disease-free survival outcomes (p < 0.001) than RFA. CONCLUSIONS: Compared with RFA, MIH provided better long-term survival outcomes in patients with early-stage HCC, with no increase in the incidence of complications. When feasible, MIH should be considered a first-line treatment for this patient population.
BACKGROUND: The advantages of radiofrequency ablation (RFA) over hepatectomy as a treatment for early-stage hepatocellular carcinoma (HCC) include reduced morbidity and more rapid recovery. Although minimally invasive surgery provides similar benefits, few studies have compared the long-term oncological outcomes of these techniques. This study aimed to compare the outcomes of minimally invasive hepatectomy (MIH) and RFA. METHODS:Patients who underwent MIH or RFA for HCC between January 2005 and January 2015 were included in a propensity score matching analysis. Only patients who underwent minimally invasive procedures for small HCC were included. Baseline clinical and laboratory parameters were retrieved from the hospital database and analyzed. RESULTS: Two hundred and twenty-five patients underwent MIH or RFA for HCC during the study period. Propensity score matching yielded 59 patient-pairs. The complication rates did not differ statistically between the 2 groups (p = 0.309). However, MIH provided significantly better overall (p = 0.005) and disease-free survival outcomes (p < 0.001) than RFA. CONCLUSIONS: Compared with RFA, MIH provided better long-term survival outcomes in patients with early-stage HCC, with no increase in the incidence of complications. When feasible, MIH should be considered a first-line treatment for this patient population.
Authors: Yang Jinhuan; Wang Yi; Zheng Yuanwen; Ma Delin; Chen Xiaotian; Wang Yan; Deng Liming; Yu Haitao; Wu Lijun; Deng Tuo; Chen Kaiyu; Hu Jiawei; Zheng Chongming; Wang Daojie; Jin Bin; Chen Gang Journal: Front Oncol Date: 2022-01-07 Impact factor: 6.244