Affordable Access

deepdyve-link
Publisher Website

Surgical resection versus radiofrequency ablation very early-stage HCC (≤2 cm Single HCC): A propensity score analysis.

Authors
  • Chu, Hee Ho1
  • Kim, Jin Hyoung1
  • Kim, Pyo Nyun1
  • Kim, So Yeon1
  • Lim, Young-Suk2
  • Park, Seong Ho1
  • Ko, Heung-Kyu1
  • Lee, Sung-Gyu3
  • 1 Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. , (North Korea)
  • 2 Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. , (North Korea)
  • 3 Department of Surgery, Division of Hepatobilliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. , (North Korea)
Type
Published Article
Journal
Liver international : official journal of the International Association for the Study of the Liver
Publication Date
Dec 01, 2019
Volume
39
Issue
12
Pages
2397–2407
Identifiers
DOI: 10.1111/liv.14258
PMID: 31549771
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Hepatocellular carcinoma (HCC) is increasingly being detected at a very early-stage due to the wide implementation of the surveillance of at-risk patient populations combined with improved imaging technologies. Whether patients with HCC at a very early stage can be offered local ablation as a first-line treatment option still remains controversial. We retrospectively compared the effectiveness of surgical resection (SR) and radiofrequency ablation (RFA) for Barcelona Clinic Liver Cancer (BCLC) very early-stage HCC in patients with long-term follow-up. Propensity score analysis using inverse probability weighting (IPW) from a large-volume liver centre. We included adult patients who between 2000 and 2013 received a diagnosis of very early-stage HCC (BCLC stage 0; a single tumour ≤2 cm, Child-Pugh A class, eastern cooperative oncology group [ECOG] 0) and who were treated with SR or RFA as the first-line treatment. We identified 1208 patients, 631 in the SR group and 577 in the RFA group. The median follow-up time was 86.2 months. After propensity score analysis using IPW, the 15-year overall survival rates were 60.4% and 51.6% in the SR and RFA group respectively. RFA group showed poorer overall survival than SR group (adjusted hazard ratio, 1.29; P = .0378). The 15-year recurrence-free survival rates were 37% and 23.6% in the SR and RFA group respectively (P < .001). For patients with very early-stage HCC, the SR group was associated with better overall and recurrence-free patient survival compared to the RFA group. Therefore, SR should be considered as the first-line treatment for these patients. © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Report this publication

Statistics

Seen <100 times