A comparison between surgical resection and radiofrequency ablation in the treatment of hepatocellular carcinoma

Abstract

PurposeThe aim of this study was to compare the therapeutic effects of radiofrequency ablation (RFA) and hepatic resection (HR) with regards to procedural morbidity, mortality, overall survival (OS) and disease-free survival (DFS) rates in hepatocellular carcinoma (HCC) patients.MethodsRetrospective studies were performed based on the medical records of 129 patients who underwent curative HR, and 57 who patients received RFA for HCC, between 2005 and 2009. The inclusion criteria of HCC were the presence of three or fewer nodules 3 cm or less in diameter or a single nodule of 5 cm or less.ResultsThe 1-, 3- and 5-year OS rates in the HR group were 91.3%, 78.8%, and 64.9%, compared to 94.4%, 74.0%, and 74.0% in the RFA group, with no significant difference between the two groups (P = 0.725). The estimated 1- and 3-year DFS rates were 70.0% and 53.0% in the HR group and 65.2% and 24.7% in the RFA group, respectively. The DFS rates of HR group were significantly higher than RFA group (P = 0.015). Multivariate analysis identified that recurrence (P = 0.036) and portal hypertension (P = 0.036) were associated with OS and that portal hypertension (P = 0.048) and increased serum α-FP (P = 0.008) were the factors significantly associated with DFS.ConclusionHCC within Milan criteria should consider hepatectomy as the primary treatment if the patient's liver function and general conditions are good enough to undergo surgical operation. But in that RFA revealed similar overall survival to HR, RFA can be an alternative therapy for patients who are eligible for surgical resection.

Outcomes of Pure Laparoscopic versus Open Hepatic Resection for Hepatocellular Carcinoma in Cirrhotic Patients: A Case-Control Study with Propensity Score Matching

“…As previously mentioned, there have been several studies that compared the long-term outcomes of LH versus OH for HCC [3,4,7,8,27], even in cirrhotic patients [9,12,29]. In addition, in this study, the OS and DFS rates were similar between the two treatment groups.…”

“…Laparoscopic hepatic resection (LH) for HCC was recently reported as a less invasive alternative to OH [3,4,5,6,7]. Moreover, the long-term outcome after LH is reportedly similar to that of OH [3,4,7,8]. In addition, the safety and efficacy of LH for cirrhotic patients, compared with OH, have recently been reported [9,10,11,12], indicating that the procedure remains challenging in advanced cases.…”

“…With the rapid development of surgical procedures and equipment for LH, minimally invasive surgery is now commonly applied in liver surgery [5], and several reports indicated good short- and long-term outcomes after LH compared with OH [3,4,5,6,7,8,9,12,26,27]. However, validation of LH for cirrhotic patients is essential because cirrhotic patients are at an exceptionally high risk for postoperative complications such as intractable ascites, pleural effusion and liver failure after OH [1,2].…”

An integrated model-based software for FUS in moving abdominal organs

“…For patients with early stage HCC, with a preserved liver function, the first line treatment option is surgical resection [40,41]. Local ablation is considered the standard of care for patients with early tumours not suitable for surgery and the local ablation techniques currently most widely used clinically are RFA and MWA.…”

Downregulation of RIP140 in hepatocellular carcinoma promoted the growth and migration of the cancer cells

“…The major risk factors include chronic hepatitis B virus and hepatitis C virus infection, aflatoxin exposure, and cirrhosis of any etiology [2][3][4][5][6]. Surgical resection or liver transplantation is usually considered the first choice of treatment for localized disease, and unresectable tumors are also treated with radiofrequency ablation or chemoembolization [7,8]. However, HCC patients succumb to the tumor-aggressive behaviors of metastasis and recurrence, deterioration of liver function, and high resistance to chemotherapy drugs, and most cases still have a poor prognosis [9].…”