Ann Surg Treat Res.  2014 Aug;87(2):72-80. 10.4174/astr.2014.87.2.72.

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

• Park EK
• Kim HJ
• Kim CY
• Hur YH
• Koh YS
• Kim JC
• Kim HJ
• Kim JW
• Cho CK

• KMID: 1882834
• DOI: http://doi.org/10.4174/astr.2014.87.2.72

Abstract

PURPOSE
The 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.
METHODS
Retrospective 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.
RESULTS
The 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 alpha-FP (P = 0.008) were the factors significantly associated with DFS.
CONCLUSION
HCC 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.

Keyword

Hepatocellular carcinoma; Catheter ablation; Hepatectomy; Survival rate

MeSH Terms

Carcinoma, Hepatocellular*
Catheter Ablation*
Disease-Free Survival
Hepatectomy
Humans
Hypertension, Portal
Liver
Medical Records
Mortality
Multivariate Analysis
Recurrence
Retrospective Studies
Survival Rate

Figure

• 

  Fig. 1 Overall (A) and disease-free survival (B) of all patients in the two treatment groups. (A) The overall survival were not significantly different (P = 0.725), in the two treatment groups. (B) But disease-free survival was significantly higher in hepatic resection (HR) group (P = 0.015). RFA, radiofrequency ablation.

• 

  Fig. 2 Disease-free survival of patients with hepatocellular carcinoma (HCC ≤ 3 cm (A) and 3 cm < HCC ≤ 5 cm (B) in the two treatment groups. (A) Disease-free survival was significantly higher in resection group (P = 0.003). (B) Disease-free survival was higher in hepatic resection (HR) group but the difference did not reach statistical significance (P = 0.099). RFA, radiofrequency ablation.

• 

  Fig. 3 Disease-free survival of patients with α-FP below 20 ng/mL and absence of portal hypertension in the two treatment groups: Disease-free survival was higher in hepatic resection (HR) group but the difference did not reach statistical significance (P = 0.228). RFA, radiofrequency ablation.

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