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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 - Ann Surg Treat Res (2014)

Bottom Line: 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 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.

View Article: PubMed Central - PubMed

Affiliation: Division of Hepatico-Biliary-Pancreatic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea.

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 α-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.

No MeSH data available.


Related in: MedlinePlus

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.
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Figure 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.

Mentions: Additionally, DFS was estimated in dividing subgroups such as HCC of 3 or less centimeters (Fig. 2A) and ranging from 3 to 5 centimeters (Fig. 2B). Mean DFS was 38.5 ± 3.4 months for HR group of 3 or less centimeters of HCC and 22.0 ± 2.6 for the RFA group, with significantly longer DFS in the HR group (P = 0.003). DFS in the subgroup ranging from 3 to 5 centimeters showed higher tendency in the HR group over RFA group, but could not reach a significant difference (P = 0.099). OS in the subgroups below and over 3 cm of HCC showed no difference between the two groups (P = 0.838 and P = 0.682, respectively).


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 - Ann Surg Treat Res (2014)

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.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4127905&req=5

Figure 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.
Mentions: Additionally, DFS was estimated in dividing subgroups such as HCC of 3 or less centimeters (Fig. 2A) and ranging from 3 to 5 centimeters (Fig. 2B). Mean DFS was 38.5 ± 3.4 months for HR group of 3 or less centimeters of HCC and 22.0 ± 2.6 for the RFA group, with significantly longer DFS in the HR group (P = 0.003). DFS in the subgroup ranging from 3 to 5 centimeters showed higher tendency in the HR group over RFA group, but could not reach a significant difference (P = 0.099). OS in the subgroups below and over 3 cm of HCC showed no difference between the two groups (P = 0.838 and P = 0.682, respectively).

Bottom Line: 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 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.

View Article: PubMed Central - PubMed

Affiliation: Division of Hepatico-Biliary-Pancreatic Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea.

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 α-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.

No MeSH data available.


Related in: MedlinePlus