Comparison of 2 curative treatment options for very early hepatocellular carcinoma Efficacy, recurrence pattern, and retreatment
- Kim, Tae Hyung; Chang, Jung Mi; Um, Soon Ho; Jee, Heejung; Lee, Yoo Ra; Lee, Han Ah; Yim, Sun Young; Han, Na Yeon; Lee, Jae Min; Choi, Hyuk Soon; Kim, Eun Sun; Yu, Young-Dong; Keum, Bora; Kim, Min Ju; An, Hyunggin; Park, Beom Jin; Seo, Yeon Seok; Kim, Dong-Sik; Yim, Hyung Joon; Cho, Sung Bum; Jeen, Yoon Tae; Lee, Hong Sik; Chun, Hoon Jai; Kim, Yun Hwan; Kim, Chang Duck
- Issue Date
- LIPPINCOTT WILLIAMS & WILKINS
- catheter ablation; hepatocellular carcinoma; recurrence; surgery; survival
- MEDICINE, v.98, no.26
- Journal Title
- Curative treatments for very early-stage hepatocellular carcinoma (HCC), defined as single HCC with a maximum diameter of < 2 cm in patients with well-preserved liver function, consist of surgical resection or radiofrequency ablation (RFA). In this retrospective study, we compared the efficacy of both treatments in 154 patients with very early-stage HCCs who underwent resection or RFA as initial therapy and were followed up for a median of 56.8 months. Propensity score matching analysis was also conducted. Overall survival was comparable between treatment groups (median survival time of 143 vs 97 months for resection and RFA, respectively; P=.132). Resection group; however, demonstrated a significantly lower recurrence rate after initial therapy than RFA group (42.3% vs 65.7%; P=.006) with a longer median recurrence-free survival time (66.7 vs 33.8 months; P=. 002), which was confirmed even after matching (P=. 04). In contrast, the recurrence pattern in advanced-stage (9.6% vs 1.0%; P=. 01) or incurable recurrences (19% vs 13%; P=. 04) was more frequent following resection than RFA. Recurrent lesions were comparatively more curable in RFA group than in resection group (80% vs 54.5%; P=. 02). The recurrence of HCC was independently associated with lower serum albumin level (P=. 027), the presence of comorbid diabetes mellitus (P=. 010), and RFA (P=. 034). In conclusion, in patients with very early-stage HCC, surgical resection has achieved significantly better recurrence-free survival than RFA. A closer follow-up is required after resection.
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- 1. Basic Science > Department of Biostatistics > 1. Journal Articles
- 2. Clinical Science > Department of Hepato-Biliary-Pancreatic Surgery > 1. Journal Articles
- 2. Clinical Science > Department of Radiology > 1. Journal Articles
- 2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
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