Liver resection versus radiofrequency ablation in the treatment of cirrhotic patients with hepatocellular carcinoma

Hepatobiliary Pancreat Dis Int. 2013 Jun;12(3):270-7. doi: 10.1016/s1499-3872(13)60044-2.

Abstract

Background: Hepatocellular carcinoma is the most common type of primary liver tumor and its incidence is increasing worldwide. The study aimed to compare patients subjected to liver resection or radiofrequency ablation.

Methods: One hundred and forty cirrhotic patients in stage A or B of Child-Pugh with single nodular or multinodular hepatocellular carcinoma were included in this retrospective study. Among them, 87 underwent surgical resection, and 53 underwent percutaneous radiofrequency ablation. Patient characteristics, survival, and recurrence-free survival were analyzed.

Results: Recurrence-free survival was longer in the resection group in comparison to the radiofrequency group with a median recurrence-free time of 36 versus 26 months, respectively (P=0.01, HR=1.52, 95% CI: 1.05-2.25). In the resection group, median survival was 46 months, with the 1-, 3- and 5-year survival rates of 89.7%, 72.4% and 40.2%. In the radiofrequency group, median survival was 32 months, with the 1-, 3- and 5-year survival rates of 83.0%, 43.4% and 22.6% (P<0.01).

Conclusions: Surgical resection improves the overall survival and recurrence-free survival in comparison with radiofrequency ablation. New evidences are needed to define the real role of the percutaneous technique as an alternative to surgery.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / etiology
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Catheter Ablation* / adverse effects
  • Catheter Ablation* / mortality
  • Chi-Square Distribution
  • Disease-Free Survival
  • Female
  • Hepatectomy* / adverse effects
  • Hepatectomy* / mortality
  • Humans
  • Kaplan-Meier Estimate
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / mortality
  • Liver Neoplasms / etiology
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Treatment Outcome