Surgical Resection Versus Radiofrequency Ablation in the Treatment of Small Unifocal Hepatocellular Carcinoma

Overview

Journal J Gastrointest Surg

Specialty Gastroenterology

Date 2008 Jul 2

PMID 18592325

Citations 35

Authors

M Abu-Hilal

J N Primrose

A Casaril

M J W McPhail

N W Pearce

N Nicoli

Affiliations

Soon will be listed here.

Abstract

Background: Hepatocellular carcinoma (HCC) has a high worldwide prevalence and mortality. While surgical resection and transplantation offers curative potential, donor availability and patient liver status and comorbidities may disallow either. Interventional radiological techniques such as radiofrequency ablation (RFA) may offer acceptable overall and disease-free survival rates.

Materials And Methods: Sixty-eight cirrhotic patients matched for age, sex, tumor size, and Child-Pugh grade with small (1-5 cm) unifocal HCC were studied retrospectively to find determinants of overall and disease-free survival in those treated with surgical resection and RFA between 1991 and 2003.

Results: Multivariate analysis using Cox proportional regression modeling showed that overall survival was related to tumor recurrence (p = 0.010), tumor diameter (p = 0.002), and treatment modality (p = 0.014); overall p = 0.008. Recurrence was independently related to the use of RFA over surgery (p = 0.023) on multivariate analysis; overall p = 0.034.

Conclusion: Surgical resection offers longer disease-free survival and potentially longer overall survival than RFA in patients with small unifocal HCC.

Citing Articles

Benefits and drawbacks of radiofrequency ablation percutaneous or minimally invasive surgery for treating hepatocellular carcinoma.

Hsieh C, Peng C, Chen C, Liu C, Teng C, Liu Y World J Gastrointest Surg. 2024; 16(11):3400-3407.

PMID: 39649197 PMC: 11622093. DOI: 10.4240/wjgs.v16.i11.3400.

Machine Learning Model Based on Prognostic Nutritional Index for Predicting Long-Term Outcomes in Patients With HCC Undergoing Ablation.

Zhang N, Lin K, Qiao B, Yan L, Jin D, Yang D Cancer Med. 2024; 13(20):e70344.

PMID: 39440446 PMC: 11496905. DOI: 10.1002/cam4.70344.

Thermal ablation versus liver resection for hepatocellular carcinoma in patients with cirrhosis: a systematic review and meta-analysis of propensity-score matched studies.

Wei Q, Xiong S, Luo W, Liang M, Luo B Clin Exp Med. 2024; 24(1):32.

PMID: 38300338 PMC: 10834626. DOI: 10.1007/s10238-023-01285-w.

Rapid Quality Assessment of Nonrigid Image Registration Based on Supervised Learning.

Lee E, Plishker W, Hata N, Shyn P, Silverman S, Bhattacharyya S J Digit Imaging. 2021; 34(6):1376-1386.

PMID: 34647199 PMC: 8669090. DOI: 10.1007/s10278-021-00523-5.

Radiofrequency ablation vs. surgical resection for resectable hepatocellular carcinoma: A systematic review and meta-analysis.

Li J, Liu X, Cui H, Xie X Mol Clin Oncol. 2019; 12(1):15-22.

PMID: 31814972 PMC: 6888042. DOI: 10.3892/mco.2019.1941.

References

Vivarelli M, Guglielmi A, Ruzzenente A, Cucchetti A, Bellusci R, Cordiano C . Surgical resection versus percutaneous radiofrequency ablation in the treatment of hepatocellular carcinoma on cirrhotic liver. Ann Surg. 2004; 240(1):102-7. PMC: 1356381. DOI: 10.1097/01.sla.0000129672.51886.44. View

Garcea G, Lloyd T, Aylott C, Maddern G, Berry D . The emergent role of focal liver ablation techniques in the treatment of primary and secondary liver tumours. Eur J Cancer. 2003; 39(15):2150-64. DOI: 10.1016/s0959-8049(03)00553-7. View

Colombo M . Nonpercutaneous therapies of hepatocellular carcinoma. Hepatogastroenterology. 2001; 48(37):25-8. View

Livraghi T, Goldberg S, Lazzaroni S, Meloni F, Solbiati L, Gazelle G . Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. Radiology. 1999; 210(3):655-61. DOI: 10.1148/radiology.210.3.r99fe40655. View

Yoshizawa H . Hepatocellular carcinoma associated with hepatitis C virus infection in Japan: projection to other countries in the foreseeable future. Oncology. 2002; 62 Suppl 1:8-17. DOI: 10.1159/000048270. View

Arii S, Yamaoka Y, Futagawa S, Inoue K, Kobayashi K, Kojiro M . Results of surgical and nonsurgical treatment for small-sized hepatocellular carcinomas: a retrospective and nationwide survey in Japan. The Liver Cancer Study Group of Japan. Hepatology. 2000; 32(6):1224-9. DOI: 10.1053/jhep.2000.20456. View

Livraghi T, Giorgio A, Marin G, Salmi A, de Sio I, Bolondi L . Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection. Radiology. 1995; 197(1):101-8. DOI: 10.1148/radiology.197.1.7568806. View

Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F . Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996; 334(11):693-9. DOI: 10.1056/NEJM199603143341104. View

Chen M, Li J, Zheng Y, Guo R, Liang H, Zhang Y . A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma. Ann Surg. 2006; 243(3):321-8. PMC: 1448947. DOI: 10.1097/01.sla.0000201480.65519.b8. View

10.

Nicoli N, Casaril A, Marchiori L, Mangiante G, Hasheminia A . Treatment of recurrent hepatocellular carcinoma by radiofrequency thermal ablation. J Hepatobiliary Pancreat Surg. 2001; 8(5):417-21. DOI: 10.1007/s005340100003. View

11.

Zhou X, Tang Z, Yang B, Lin Z, Ma Z, Ye S . Experience of 1000 patients who underwent hepatectomy for small hepatocellular carcinoma. Cancer. 2001; 91(8):1479-86. DOI: 10.1002/1097-0142(20010415)91:8<1479::aid-cncr1155>3.0.co;2-0. View

12.

Hong S, Lee S, Choi M, Lee J, Koh K, Paik S . Comparing the outcomes of radiofrequency ablation and surgery in patients with a single small hepatocellular carcinoma and well-preserved hepatic function. J Clin Gastroenterol. 2005; 39(3):247-52. DOI: 10.1097/01.mcg.0000152746.72149.31. View

13.

Wakai T, Shirai Y, Suda T, Yokoyama N, Sakata J, Cruz P . Long-term outcomes of hepatectomy vs percutaneous ablation for treatment of hepatocellular carcinoma < or =4 cm. World J Gastroenterol. 2006; 12(4):546-52. PMC: 4066085. DOI: 10.3748/wjg.v12.i4.546. View

14.

Izumi N, Asahina Y, Noguchi O, Uchihara M, Kanazawa N, Itakura J . Risk factors for distant recurrence of hepatocellular carcinoma in the liver after complete coagulation by microwave or radiofrequency ablation. Cancer. 2001; 91(5):949-56. View

15.

Kosuge T, Makuuchi M, Takayama T, Yamamoto J, Shimada K, Yamasaki S . Long-term results after resection of hepatocellular carcinoma: experience of 480 cases. Hepatogastroenterology. 1993; 40(4):328-32. View

16.

Horigome H, Nomura T, Nakao H, Saso K, Takahashi Y, Akita S . Treatment of solitary small hepatocellular carcinoma: consideration of hepatic functional reserve and mode of recurrence. Hepatogastroenterology. 2000; 47(32):507-11. View

17.

Colombo M, de Franchis R, Del Ninno E, Sangiovanni A, De Fazio C, Tommasini M . Hepatocellular carcinoma in Italian patients with cirrhosis. N Engl J Med. 1991; 325(10):675-80. DOI: 10.1056/NEJM199109053251002. View

18.

Makuuchi M, Imamura H, Sugawara Y, Takayama T . Progress in surgical treatment of hepatocellular carcinoma. Oncology. 2002; 62 Suppl 1:74-81. DOI: 10.1159/000048280. View

19.

Kiyosawa K, Tanaka E . Characteristics of hepatocellular carcinoma in Japan. Oncology. 2002; 62 Suppl 1:5-7. DOI: 10.1159/000048269. View

20.

Utsunomiya T, Shimada M, Taguchi K, Hasegawa H, Yamashita Y, Hamatsu T . Clinicopathologic features and postoperative prognosis of multicentric small hepatocellular carcinoma. J Am Coll Surg. 2000; 190(3):331-5. DOI: 10.1016/s1072-7515(99)00268-9. View