Hee Ho Chu1, Jin Hyoung Kim1, Pyo Nyun Kim1, So Yeon Kim1, Young-Suk Lim2, Seong Ho Park1, Heung-Kyu Ko1, Sung-Gyu Lee3. 1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 2. Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 3. Department of Surgery, Division of Hepatobilliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Abstract
BACKGROUND & AIM: Hepatocellular carcinoma (HCC) is increasingly being detected at a very early-stage due to the wide implementation of the surveillance of at-risk patient populations combined with improved imaging technologies. Whether patients with HCC at a very early stage can be offered local ablation as a first-line treatment option still remains controversial. We retrospectively compared the effectiveness of surgical resection (SR) and radiofrequency ablation (RFA) for Barcelona Clinic Liver Cancer (BCLC) very early-stage HCC in patients with long-term follow-up. METHODS: Propensity score analysis using inverse probability weighting (IPW) from a large-volume liver centre. We included adult patients who between 2000 and 2013 received a diagnosis of very early-stage HCC (BCLC stage 0; a single tumour ≤2 cm, Child-Pugh A class, eastern cooperative oncology group [ECOG] 0) and who were treated with SR or RFA as the first-line treatment. RESULTS: We identified 1208 patients, 631 in the SR group and 577 in the RFA group. The median follow-up time was 86.2 months. After propensity score analysis using IPW, the 15-year overall survival rates were 60.4% and 51.6% in the SR and RFA group respectively. RFA group showed poorer overall survival than SR group (adjusted hazard ratio, 1.29; P = .0378). The 15-year recurrence-free survival rates were 37% and 23.6% in the SR and RFA group respectively (P < .001). CONCLUSION: For patients with very early-stage HCC, the SR group was associated with better overall and recurrence-free patient survival compared to the RFA group. Therefore, SR should be considered as the first-line treatment for these patients.
BACKGROUND & AIM: Hepatocellular carcinoma (HCC) is increasingly being detected at a very early-stage due to the wide implementation of the surveillance of at-risk patient populations combined with improved imaging technologies. Whether patients with HCC at a very early stage can be offered local ablation as a first-line treatment option still remains controversial. We retrospectively compared the effectiveness of surgical resection (SR) and radiofrequency ablation (RFA) for Barcelona Clinic Liver Cancer (BCLC) very early-stage HCC in patients with long-term follow-up. METHODS: Propensity score analysis using inverse probability weighting (IPW) from a large-volume liver centre. We included adult patients who between 2000 and 2013 received a diagnosis of very early-stage HCC (BCLC stage 0; a single tumour ≤2 cm, Child-Pugh A class, eastern cooperative oncology group [ECOG] 0) and who were treated with SR or RFA as the first-line treatment. RESULTS: We identified 1208 patients, 631 in the SR group and 577 in the RFA group. The median follow-up time was 86.2 months. After propensity score analysis using IPW, the 15-year overall survival rates were 60.4% and 51.6% in the SR and RFA group respectively. RFA group showed poorer overall survival than SR group (adjusted hazard ratio, 1.29; P = .0378). The 15-year recurrence-free survival rates were 37% and 23.6% in the SR and RFA group respectively (P < .001). CONCLUSION: For patients with very early-stage HCC, the SR group was associated with better overall and recurrence-free patient survival compared to the RFA group. Therefore, SR should be considered as the first-line treatment for these patients.
Authors: Jeong Hee Yoon; Jeong Min Lee; Dong Ho Lee; Ijin Joo; Ju Hyun Jeon; Su Joa Ahn; Seung-Taek Kim; Eun Ju Cho; Jeong-Hoon Lee; Su Jong Yu; Yoon Jun Kim; Jung-Hwan Yoon Journal: Liver Cancer Date: 2020-08-06 Impact factor: 11.740
Authors: Hee Ho Chu; Jin Hyoung Kim; Ju Hyun Shim; Sang Min Yoon; Pyeong Hwa Kim; Ibrahim Alrashidi Journal: Cancers (Basel) Date: 2020-04-29 Impact factor: 6.639
Authors: Chan Park; Jin Hyoung Kim; Pyeong Hwa Kim; So Yeon Kim; Dong Il Gwon; Hee Ho Chu; Minho Park; Joonho Hur; Jin Young Kim; Dong Joon Kim Journal: Korean J Radiol Date: 2020-08-28 Impact factor: 3.500
Authors: Bin Zheng Ms; Heng Wang Ms; Jin-Xue Wang Ms; Zheng-Hong Liu Ms; Pu Zhang Md; Dahong Zhang Md Journal: Technol Cancer Res Treat Date: 2021 Jan-Dec