A randomized controlled trial of radiofrequency ablation and surgical resection in the treatment of small hepatocellular carcinoma

Feng, Kai; Yan, Jun; Li, Xiaowu; Xia, Feng; Ma, Kui; Wang, Shuguang; Bie, Ping; Dong, Jiahong

doi:10.1016/j.jhep.2012.05.007

Cited by 633 publications

(553 citation statements)

References 32 publications

Supporting

Mentioning

497

Contrasting

Unclassified

Order By: Relevance

“…A recent meta‐analysis28, including three RCTs11, 12, 13 and several retrospective studies14, 15, 16 comparing RFA with surgical resection, concluded that RFA was comparable to surgical resection in terms of survival, with lower complication rates but higher recurrence rates, consistent with the present results. A study29 comparing RFA with surgical resection for solitary small HCC using a propensity score model showed that surgical resection provided better OS and RFS than RFA.…”

Section: Discussionsupporting

confidence: 87%

See 1 more Smart Citation

Propensity score‐matched comparison of non‐anatomical resection and radiofrequency ablation for hepatocellular carcinoma in patients with up to three tumours, each measuring up to 3 cm in diameter

et al. 2018

View full text Add to dashboard Cite

BackgroundNon‐anatomical liver resection (NAR) and radiofrequency ablation (RFA) are treatment options for early‐stage hepatocellular carcinoma (HCC). The aim was to compare the outcomes of NAR and RFA for HCC in patients with three or fewer tumour nodules, each measuring not more than 3 cm in maximum diameter.MethodsEligible patients undergoing NAR or RFA with curative intent between September 2002 and December 2014 were identified. A propensity score‐matching analysis was performed to reduce bias, and outcomes in these patients were analysed.ResultsFrom a total of 199 patients, 1:1 propensity score matching identified 70 matched pairs. Patients having NAR had a longer hospital stay (median 10 days versus 4 days for those who had RFA; P < 0·001) and a higher morbidity rate (24 versus 10 per cent respectively; P = 0·042). Patients who had NAR had slightly better recurrence‐free survival but this failed to reach statistical significance in univariable analysis (P = 0·064). There was no significant difference in overall survival between the two groups (P = 0·475). RFA was identified as an independent risk factor for recurrence‐free survival (hazard ratio (HR) 1·57; P = 0·041) in multivariable analysis. Local recurrence was significantly more common in patients receiving RFA (23 versus 1 per cent; P < 0·001).ConclusionRFA was an independent risk factor for shorter recurrence‐free survival, with a significantly higher local recurrence rate than NAR. Despite these differences, overall survival was not affected.

show abstract

Section: Discussionsupporting

confidence: 87%

“…To date, three RCTs11, 12, 13 and several retrospective studies14, 15, 16 comparing RFA with surgical resection have been reported, with contradictory findings reflecting different inclusion criteria.…”

Section: Introductionmentioning

confidence: 99%

Propensity score‐matched comparison of non‐anatomical resection and radiofrequency ablation for hepatocellular carcinoma in patients with up to three tumours, each measuring up to 3 cm in diameter

et al. 2018

View full text Add to dashboard Cite

show abstract

“…This technique is being applied in several Asian countries with good results [43,44] . Several randomized controlled trials compared the efficacy of RFA with that of resection in Asian patients with HCC meeting the Milan criteria [45,46] . Pooled data demonstrated no significant differences in overall survival or recurrence-free survival between the treatments at 1 and 3 years.…”

Section: Interventional Therapiesmentioning

confidence: 99%

Current management of hepatocellular carcinoma: An Eastern perspective

Yim¹

2015

WJG

View full text Add to dashboard Cite

show abstract

“…Its efficacy in the treatment of small HCC is comparable to that of surgical resection [11] . Radiofrequency ablation can not only resect the tumor itself but is also effective in sealing vessels and bile ducts, which can facilitate nearly bloodless liver resection [23] .…”

Section: Discussionmentioning

confidence: 96%

“…In recent years, the continuous use and development of radiofrequency ablation (RFA) in liver surgery have produced satisfactory results in the treatment of small HCC. It can also block small and medium-sized blood vessels in the liver through thermal coagulation, so it has been used in liver resection in order to reduce bleeding [11][12][13] . Radiofrequency-assisted hepatectomy was first described by Weber et al [12] who used a single needle probe to deploy RFA energy before liver resection, and the mean blood loss during the surgery was only 30 ± 10 mL in 15 patients.…”

Section: Introductionmentioning

confidence: 99%

Efficiency and safety of radiofrequency-assisted hepatectomy for hepatocellular carcinoma with cirrhosis: A single-center retrospective cohort study

Zhang¹,

Yan²,

Feng³

et al. 2015

WJG

Self Cite

View full text Add to dashboard Cite

AIM:To assess the efficiency and safety of radiofrequencyassisted hepatectomy in patients with hepatocellular carcinoma (HCC) and cirrhosis. METHODS:From January 2010 to December 2013, 179 patients with HCC and cirrhosis were recruited for this retrospective study. Of these, 100 patients who received radiofrequency-assisted hepatectomy (RF+ group) were compared to 79 patients who had hepatectomy without ablation (RF-group). The primary endpoint was intraoperative blood loss. The secondary endpoints included liver function, postoperative complications, mortality, and duration of hospital stay. RESULTS:The characteristics of the two groups were closely matched. The Pringle maneuver was not used in the RF+ group. There was significantly less median intraoperative blood loss in the RF+ group (300 vs 400 mL, P = 0.01). On postoperative days (POD) 1 and 5, median alanine aminotransferase was significantly higher in the RF+ group than in the RF-group (POD 1: 348.5 vs 245.5, P = 0.01; POD 5: 112 vs 82.5, P = 0.00), but there was no significant difference between the two groups on POD 3 (260 vs 220, P = 0.24). The median AST was significantly higher in the RF+ group on POD 1 (446 vs 268, P = 0.00), but there was no significant difference between the two groups on POD 3 and 5 (POD 3: 129.5 vs 125, P = 0.65; POD 5: 52.5 Core tip: The purpose of this study was to assess the efficiency and safety of radiofrequency-assisted hepatectomy in patients with hepatocellular carcinoma and cirrhosis. Radiofrequency-assisted hepatectomy can reduce intraoperative blood loss during liver resection effectively. However, this method should be used with caution in patients with concomitant cirrhosis because it may cause severe liver damage and even liver failure.Zhang F, Yan J, Feng XB, Xia F, Li XW, Ma KS, Bie P. Efficiency and safety of radiofrequency-assisted hepatectomy for hepatocellular carcinoma with cirrhosis: A single-center retrospective cohort study.

show abstract

A randomized controlled trial of radiofrequency ablation and surgical resection in the treatment of small hepatocellular carcinoma

Cited by 633 publications

References 32 publications

Propensity score‐matched comparison of non‐anatomical resection and radiofrequency ablation for hepatocellular carcinoma in patients with up to three tumours, each measuring up to 3 cm in diameter

Propensity score‐matched comparison of non‐anatomical resection and radiofrequency ablation for hepatocellular carcinoma in patients with up to three tumours, each measuring up to 3 cm in diameter

Current management of hepatocellular carcinoma: An Eastern perspective

Efficiency and safety of radiofrequency-assisted hepatectomy for hepatocellular carcinoma with cirrhosis: A single-center retrospective cohort study

Contact Info

Product

Resources

About