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Radiofrequency Ablation Versus Surgical Resection for Hepatocellular Carcinoma in Childs A Cirrhotics—a Retrospective Study of 1,061 Cases

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

The long-term outcomes of radiofrequency ablation (RFA) vs. surgical resection in cirrhotic patients with hepatocellular carcinoma (HCC) remain controversial. One thousand sixty-one cirrhotic HCC patients were included into a retrospective study. Four hundred thirteen received RFA and 648 received surgical resection.

Results

Overall (OS), recurrence-free (RFS), and tumor-free survival (TFS) were compared between the two groups and in subgroup analyses. The 5-year OS and corresponding RFS as well as DFS were significantly higher in the surgical resection group compared with the RFA group (p < 0.001, p < 0.001, p < 0.001). In subgroup analyses of solitary HCC ≤3 cm, there was no significant difference in RFS between the two groups (p = 0.719). Nonetheless, surgical resection was superior to RFA for OS and TFS in this subgroup as well as for OS, RFS, and TFS in subgroup analyses for solitary lesions 3 cm < HCC < 5 cm and multifocal HCC. Serum AFP was the only significant predicting factor for all survival analyses.

Conclusions

When treating Childs A cirrhotic patients with solitary HCC larger than 3 cm but less than 5 cm, or with two or three lesions each less than 5 cm, surgical resection provides a better survival than RFA. When treating Childs A cirrhotics with solitary HCC ≤ 3 cm, RFA has a comparable RFS to surgical resection, but RFA is less invasive.

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Authors and Affiliations

  1. Department of Hepato-Biliary-Pancreatic Surgery, Treatment Centre of Liver Cancer, West China Hospital, Sichuan University, Chengdu, Sichuan, China

    Jiwei Huang, Lvnan Yan, Hong Wu, Zheyu Chen, Pankaj Prasoon & Yong Zeng

  2. From Department of Surgery, University of Western Ontario, Hepatobiliary and Liver Transplant Surgery, London Health Sciences Centre, London, Ontario, Canada

    Roberto Hernandez-Alejandro & Kristopher P. Croome

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  1. Jiwei Huang
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  2. Roberto Hernandez-Alejandro
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  3. Kristopher P. Croome
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  4. Lvnan Yan
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  5. Hong Wu
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  8. Yong Zeng
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Correspondence to Yong Zeng.

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Huang, J., Hernandez-Alejandro, R., Croome, K.P. et al. Radiofrequency Ablation Versus Surgical Resection for Hepatocellular Carcinoma in Childs A Cirrhotics—a Retrospective Study of 1,061 Cases. J Gastrointest Surg 15, 311–320 (2011). https://doi.org/10.1007/s11605-010-1372-y

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  • DOI: https://doi.org/10.1007/s11605-010-1372-y

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