Comparison of laparoscopic hepatectomy, percutaneous radiofrequency ablation and open hepatectomy in the treatment of small hepatocellular carcinoma

Abstract

Abstract:Objective: Three mainstream techniques-laparoscopic hepatectomy (LH), percutaneous radiofrequency ablation (pRFA), and open hepatectomy (OH)-were compared in this study, in terms of their efficacies in the treatment of small hepatocellular carcinoma (HCC). Methods: A comparative study was performed within a total of 94 patients diagnosed with small HCC in our hospital from 2005 to 2010, who underwent LH (28), RFA (33), or OH (33). They had either a single tumor lesion of less than 5 cm or up to three nodules with diameters of less than 3 cm each. Outcomes were carefully evaluated throughout a 3-year follow-up interval and statistically interpreted. Results: The pRFA group had a significantly lower disease-free survival rate compared with the two surgical groups (P=0.001) and significantly shorter overall survival (P=0.005), while the LH group and the OH group had no difference in survival results. For patients younger than 60 years old, surgical approaches offered a better long-term overall survival prognosis (P=0.008). There were no statistically significant differences among the three groups in overall survival for elderly patients (P=0.104). Conclusions: Among patients with small HCC, LH may provide better curative effects than pRFA without increasing complication rates. pRFA leads to faster recurrence than surgical resections. LH has similar therapeutic effects to OH and causes less trauma. For patients younger than 60 years old, LH may be the best curative treatment. Elderly patients may choose either surgery or pRFA.

Meta-analysis of short- and long-term outcomes after pure laparoscopic versus open liver surgery in hepatocellular carcinoma patients

“…We estimated the volume of hospitals where studies were performed. Some institutes were noticeably very high-volume centers with almost 3000 cases in 6 years [ 39 ], while others performed as few as 60 procedures in 5 years [ 61 ].…”

Meta‐analysis of laparoscopic versus open liver resection for hepatocellular carcinoma

“…Through the preliminary search, 990 articles are obtained. After reading titles and abstracts and full texts and removing duplicate documents, 47 articles were included in our study, which involved 5889 patients (Fig. ).…”

“…The safety and feasibility of laparoscopic hepatectomy have been reported by many previous series. 14,21,23,24,26 From controversy to acceptance, LH has developed over the last 20 years in terms of technological innovations, improvements in surgical techniques, and accumulation of experience by surgeons. In this series, we reviewed the development of LH and its current status.…”

Radiofrequency ablation versus laparoscopic hepatectomy for treatment of hepatocellular carcinoma: a systematic review and meta-analysis

“…The sample sizes varied from 46 to 156 patients. Five studies [10,[18][19][20][21] were conducted in China. The mean age of patients varied from 48 to 73 years old.…”

“…Although surgery provides the best option for patients with hepatic tumors, less than 30% of patients with HCC have an opportunity to undergo surgery [8]. Previous studies [9][10][11] have demonstrated that local ablation, especially radiofrequency ablation (RFA), can also achieve radical cure effects on HCC, and its short-and long-term survival rates are comparable and even similar to surgery strategies. In addition, RFA treatment has the advantages of mild trauma, low risk of bleeding, and high reproducibility compared with surgery.…”