Mengchao Wei1, Manxia Lin2, Xian Zhong2, Zihao Dai1, Shunli Shen1, Shaoqiang Li1, Zhenwei Peng3,4,5, Ming Kuang6,7,8,9. 1. Department of Liver Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China. 2. Division of Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. 3. Department of Radiation Oncology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China. pzhenw@mail.sysu.edu.cn. 4. Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. pzhenw@mail.sysu.edu.cn. 5. Institute of Precision Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. pzhenw@mail.sysu.edu.cn. 6. Department of Liver Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China. kuangm@mail.sysu.edu.cn. 7. Division of Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. kuangm@mail.sysu.edu.cn. 8. Institute of Precision Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. kuangm@mail.sysu.edu.cn. 9. Cancer Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. kuangm@mail.sysu.edu.cn.
Abstract
BACKGROUND: Imaging traits including nonsmooth tumor margins, internal arteries, peritumoral enhancement, and absence of hypodense halos can reflect tumor aggressiveness preoperatively and may affect treatment selection. This study aimed to explore the role of these four imaging traits in treatment selection between surgical resection (SR) and radiofrequency ablation (RFA) for patients with single ≤ 5 cm hepatocellular carcinoma (HCC). PATIENTS AND METHODS: Three hundred eight-one patients with single ≤ 5 cm HCC who underwent SR (n = 202) or RFA (n = 179) in the First Affiliated Hospital of Sun Yat-sen University from April 2010 to December 2019 were retrospectively enrolled. The efficacy of SR and RFA in patients with the imaging traits that significantly influenced recurrence-free survival (RFS) or overall survival (OS) was compared and analyzed. RESULTS: Multivariable Cox regression analysis identified that having internal arteries (P = 0.001) was an independent influencing factor for RFS, while internal arteries (P = 0.005) and peritumoral enhancement (P = 0.001) were independent influencing factors for OS. In patients with internal arteries, subgroup analysis based on tumor size demonstrated that both RFS and OS of SR were superior to those of RFA in patients with 3-5 cm HCC (RFS, P = 0.023; OS, P = 0.015). In patients with peritumoral enhancement, both RFS and OS of SR were superior to those of RFA (RFS, P = 0.019; OS, P = 0.042). CONCLUSION: SR may be associated with improved survival compared with RFA in patients with single 3-5 cm HCC having internal arteries and patients with single ≤ 5 cm HCC having peritumoral enhancement.
BACKGROUND: Imaging traits including nonsmooth tumor margins, internal arteries, peritumoral enhancement, and absence of hypodense halos can reflect tumor aggressiveness preoperatively and may affect treatment selection. This study aimed to explore the role of these four imaging traits in treatment selection between surgical resection (SR) and radiofrequency ablation (RFA) for patients with single ≤ 5 cm hepatocellular carcinoma (HCC). PATIENTS AND METHODS: Three hundred eight-one patients with single ≤ 5 cm HCC who underwent SR (n = 202) or RFA (n = 179) in the First Affiliated Hospital of Sun Yat-sen University from April 2010 to December 2019 were retrospectively enrolled. The efficacy of SR and RFA in patients with the imaging traits that significantly influenced recurrence-free survival (RFS) or overall survival (OS) was compared and analyzed. RESULTS: Multivariable Cox regression analysis identified that having internal arteries (P = 0.001) was an independent influencing factor for RFS, while internal arteries (P = 0.005) and peritumoral enhancement (P = 0.001) were independent influencing factors for OS. In patients with internal arteries, subgroup analysis based on tumor size demonstrated that both RFS and OS of SR were superior to those of RFA in patients with 3-5 cm HCC (RFS, P = 0.023; OS, P = 0.015). In patients with peritumoral enhancement, both RFS and OS of SR were superior to those of RFA (RFS, P = 0.019; OS, P = 0.042). CONCLUSION: SR may be associated with improved survival compared with RFA in patients with single 3-5 cm HCC having internal arteries and patients with single ≤ 5 cm HCC having peritumoral enhancement.
Authors: Martin J Heslin; Brandon A Singletary; Kaitlin C Benos; Laura Read Lee; Charles Fry; Brenessa Lindeman Journal: Ann Surg Date: 2019-09 Impact factor: 12.969
Authors: Allen L Hoffman; Sandy S Wu; Amal K Obaid; Samuel W French; Juan Lois; Michael McMonigle; Hector C Ramos; Linda S Sher; Richard R Lopez Journal: Am Surg Date: 2002-12 Impact factor: 0.688