From the Insitute of Hepatobiliary Surgery,Southwest Hospital,Third Military Medical University ,Chongqing, China.
BACKGROUND & AIMS:
The aim of this study was to compare the efficacy of radiofrequency ablation (RFA) and surgical resection (RES) in the treatment of small hepatocellular carcinoma (HCC).
A total of 168 patients with small HCC with nodular diameters of less than 4 cm and up to 2 nodules were randomly divided into RES (n = 84) and RFA groups (n = 84). Outcomes were carefully monitored and evaluated during the three-year follow-up period.
The 1-, 2- and 3-year survival rates for the RES and the RFA groups were 96.0%, 87.6%, 74.8% and 93.1%, 83.1%, 67.2%, respectively. The corresponding recurrence-free survival rates for the two groups were 90.6%, 76.7%, 61.1% and 86.2%, 66.6%, 49.6%, respectively. There were no statistically significant differences between the two groups in overall survival rate (P = 0.342) or recurrence-free survival rate (P = 0.122). Multivariate analysis demonstrated that the independent risk factors associated with survival were multiple occurrences of tumors in different hepatic locations (relative risk of 2.696; 95% CI: 1.189 -6.117; P = 0.018) and preoperative indocyanine green retention rate at 15 minutes (ICG-15) (relative risk of 3.853; 95% CI: 1.647 -9.015; P = 0.002).
Percutaneous RFA may provide therapeutic effects for patients with small hepatocellular carcinomas that are similar to those of RES. However, for the treatment of small HCC located at specific sites of the liver, percutaneous RFA is more likely to be incomplete, and open or laparoscopic surgery may be the better choice.