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Percutaneous Radiofrequency Ablation Versus Partial Hepatectomy for Small Centrally Located Hepatocellular Carcinoma

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Abstract

Background

It is not known whether percutaneous radiofrequency ablation (PRFA) could get the same treatment efficacy and fewer complications as partial hepatectomy (PH) in patients with small centrally located hepatocellular carcinoma (HCC). The present study was designed to evaluate the efficacy of PH and PRFA in the treatment of small centrally located HCC.

Methods

From January 2002 until December 2007, 196 patients with small centrally located HCC (≤5 cm) were included. Of these 196 patients, 94 received PRFA and 102 patients were treated with PH. Treatment outcomes, including major complications and survival data, were studied.

Results

No treatment-related death occurred in either group. There were no significant differences in survival rates between the two groups. The 1-, 3-, and 5-year disease-free survival rates for the PRFA and PH groups were 57.9 %, 36.4 %, 34.0 %, and 59.8 %, 42.4 %, 40.8 %, respectively (P = 0.50). The 1-, 3-, and 5-year overall survival rates for the two groups were 94.3 %, 74.7 %, and 49.8 %, and 89.2 %, 74.1 %, and 63.1 %, respectively (P = 0.96). PRFA had a lower rate of major complications than PH (8.5 vs 19.6 %), and the hospital stay was also shorter in the PRFA group than in the PH subgroup (4 vs 13 days).

Conclusions

Based on the data obtained, we concluded that PRFA might be equal to PH for the treatment of small centrally located HCC. However, PRFA has the benefits of shorter hospital stay as well as a lower rate of complications.

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References

  1. Liver Cancer Study Group of Japan (1980) Primary liver cancers in Japan. Cancer 45:2663–2669

    Article  Google Scholar 

  2. Lai EC, Fan ST, Lo CM et al (1995) Hepatic resection for hepatocellular carcinoma: an audit of 343 patients. Ann Surg 221:291–298

    Article  PubMed  CAS  Google Scholar 

  3. Lau WY, Leung TW, Yu SC et al (2003) Percutaneous local ablative therapy for hepatocellular carcinoma: a review and look into the future. Ann Surg 237:171–179

    PubMed  CAS  Google Scholar 

  4. Lee JG, Choi SB, Kim KS et al (2008) Central bisectionectomy for centrally located hepatocellular carcinoma. Br J Surg 95:990–995

    Article  PubMed  CAS  Google Scholar 

  5. Stratopoulos C, Soonawalla Z, Brockmann J et al (2007) Central hepatectomy: the golden mean for treating central liver tumors? Surg Oncol 16:99–106

    Article  PubMed  Google Scholar 

  6. Mehrabi A, Mood ZA, Roshanaei N et al (2008) Mesohepatectomy as an option for the treatment of central liver tumors. J Am Coll Surg 207:499–509

    Article  PubMed  Google Scholar 

  7. Chen J-Y, Chau G-Y, Lui W-Y et al (2003) Clinicopathologic features and factors related to survival of patients with small hepatocellular carcinoma after hepatic resection. World J Surg 27:294–298. doi:10.1007/s00268-002-6539-6

    Article  PubMed  Google Scholar 

  8. De Matteo RP, Palese C, Jarnagin WR et al (2000) Anatomical segmental hepatic resection is superior to wedge resection as an oncological operation for colorectal liver metastases. J Gastrointest Surg 4:178–184

    Article  Google Scholar 

  9. Curley SA (2001) Radiofrequency ablation of malignant liver tumors. Oncologist 6:14–23

    Article  PubMed  CAS  Google Scholar 

  10. Mulier S, Mulier P, Ni Y et al (2002) Complications of radiofrequency coagulation of liver tumours. Br J Surg 89:1206–1222

    Article  PubMed  CAS  Google Scholar 

  11. Chen MS, Li JQ, Zheng Y et al (2006) A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma. Ann Surg 243:321–328

    Article  PubMed  Google Scholar 

  12. Chen MH, Yang W, Yan K et al (2008) Radiofrequency ablation of problematically located hepatocellular carcinoma: tailored approach. Abdom Imaging 33:428–436

    Article  PubMed  Google Scholar 

  13. Guo WX, Zhai B, Lai EC et al (2010) Percutaneous radiofrequency ablation versus partial hepatectomy for multicentric small hepatocellular carcinomas: a nonrandomized comparative study. World J Surg 34:2671–2676. doi:10.1007/s00268-010-0732-9

    Article  PubMed  Google Scholar 

  14. Lau WY, Lai EC (2009) The current role of radiofrequency ablation in the management of hepatocellular carcinoma: a systematic review. Ann Surg 249:20–25

    Article  PubMed  Google Scholar 

  15. Hu RH, Lee PH, Chang YC et al (2003) Treatment of centrally located hepatocellular carcinoma with central hepatectomy. Surgery 133:251–256

    Article  PubMed  Google Scholar 

  16. Wu CC, Ho WL, Chen JT et al (1999) Mesohepatectomy for centrally located hepatocellular carcinoma: an appraisal of a rare procedure. J Am Coll Surg 188:508–515

    Article  PubMed  CAS  Google Scholar 

  17. Scudamore CH, Buczkowski AK, Shayan H et al (2000) Mesohepatectomy. Am J Surg 179:356–360

    Article  PubMed  CAS  Google Scholar 

  18. Lam VW, Ng KK, Chok KS et al (2008) Safety and efficacy of radiofrequency ablation for periductal hepatocellular carcinoma with intraductal cooling of the central bile duct. J Am Coll Surg 207:e1–e5

    Article  PubMed  Google Scholar 

  19. Lu DS, Raman SS, Limanond P et al (2003) Influence of large peritumoral vessels on outcome of radiofrequency ablation of liver tumors. J Vasc Interv Radiol 14:1267–1274

    Article  PubMed  Google Scholar 

  20. Wiersinga WJ, Jansen MC, Straatsburg IH et al (2003) Lesion progression with time and the effect of vascular occlusion following radiofrequency ablation of the liver. Br J Surg 90:306–312

    Article  PubMed  CAS  Google Scholar 

  21. Chouillard E, Cherqui D, Tayar C et al (2003) Anatomical bi- and trisegmentectomies as alternatives to extensive liver resections. Ann Surg 238:29–34

    PubMed  Google Scholar 

  22. Nakajima Y, Shimamura T, Kamiyama T et al (1996) Evaluation of surgical resection for small hepatocellular carcinoma. Am J Surg 171:360–363

    Article  PubMed  CAS  Google Scholar 

  23. Chau GY, Lui WY, Tsay SH et al (1997) Prognostic significance of surgical margin in hepatocellular carcinoma resection: an analysis of 165 Childs’ A patients. J Surg Oncol 66:122–126

    Article  PubMed  CAS  Google Scholar 

  24. Lui WY, Chau GY, Loong CC et al (1995) Hepatic segmentectomy for curative resection of primary hepatocellular carcinoma. Arch Surg 130:1090–1097

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This work was supported by Science Fund for Creative Research Groups (No: 30921006), China National Funds for Distinguished Young Scientists No: (81125018), New Excellent Talents Program of Shanghai Municipal Health Bureau (No: XBR2011025). New Excellent Talents Program of Shanghai Science and Technology Committee (No: 10XD1405800).

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Authors and Affiliations

  1. Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, No. 225 Changhai Road, Shanghai, 200438, People’s Republic of China

    Wei-Xing Guo, Ju-Xian Sun, Yu-Qiang Cheng, Jie Shi, Nan Li, Jie Xue, Meng-Chao Wu, Yi Chen & Shu-Qun Cheng

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  1. Wei-Xing Guo
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  2. Ju-Xian Sun
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  3. Yu-Qiang Cheng
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  4. Jie Shi
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  5. Nan Li
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  6. Jie Xue
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  7. Meng-Chao Wu
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  8. Yi Chen
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  9. Shu-Qun Cheng
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Corresponding authors

Correspondence to Yi Chen or Shu-Qun Cheng.

Additional information

Wei-Xing Guo, Ju-Xian Sun, and Yu-Qiang Cheng contributed equally to this study.

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Guo, WX., Sun, JX., Cheng, YQ. et al. Percutaneous Radiofrequency Ablation Versus Partial Hepatectomy for Small Centrally Located Hepatocellular Carcinoma. World J Surg 37, 602–607 (2013). https://doi.org/10.1007/s00268-012-1870-z

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  • DOI: https://doi.org/10.1007/s00268-012-1870-z

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