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Superior long-term outcomes after surgery in child-pugh class a patients with single small hepatocellular carcinoma compared to radiofrequency ablation

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Abstract

Background and aims

There are insufficient data comparing long-term prognoses after radiofrequency ablation (RFA) and surgery.

Methods

We compared the baseline characteristics and survival rates of patients (single, ≤3 cm, and Child-Pugh class A) treated surgically (n = 215) and with RFA (n = 255) from January 2000 to December 2007 at our institution.

Results

The surgery group was characterized by younger age, higher prevalence of HBsAg, less cirrhosis, and an increased chance of Child-Pugh score of 5 and CLIP score of 1, compared to the RFA group. During the median follow-up period of 42 months (range 1–109), the 3-, 5- and 7-year overall survival rates in the surgery group were 98, 94, and 94%, respectively, which were significantly higher than those in the RFA group (92, 87, and 76%, respectively, P = 0.002). The 3- and 5-year recurrence-free survival rates were 72 and 66%, respectively, in the surgery group, which were significantly higher than those in the RFA group (34 and 24%, respectively, P < 0.001). The superiority of the survival rates in the surgery group persisted in most patients throughout the subgroup analysis, based on the Child-Pugh score and CLIP score. Multivariate analysis showed that age and surgery as a procedure type were the significant predictive factors for both overall survival [HR = 1.04 (CI 1.001–1.08), P = 0.047 for age; HR = 2.97 (CI 1.19–7.45), P = 0.02 for surgery] and recurrence-free survival [HR = 1.02 (CI 1.01–1.04), P = 0.01 for age; HR = 2.44 (CI 1.76–3.37), P < 0.001 for surgery].

Conclusions

The long-term outcome after surgery for Child-Pugh class A and single small HCC is superior to that after RFA.

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Acknowledgements

This study was supported by a Samsung Medical Centre Clinical Research Development Program grant (CRL 105-91-4).

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Authors and Affiliations

  1. Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea

    Won Kyoung Yun, Moon Seok Choi, Kyung Hee Kim, Tae Hoon Jang, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik & Byung Chul Yoo

  2. Department of Radiology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea

    Dongil Choi & Hyun-Chul Rhim

  3. Department of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea

    Jae Won Joh

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  1. Won Kyoung Yun
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  2. Moon Seok Choi
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Corresponding author

Correspondence to Byung Chul Yoo.

Additional information

W. K. Yun and M. S. Choi contributed equally to this work.

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Yun, W.K., Choi, M.S., Choi, D. et al. Superior long-term outcomes after surgery in child-pugh class a patients with single small hepatocellular carcinoma compared to radiofrequency ablation. Hepatol Int 5, 722–729 (2011). https://doi.org/10.1007/s12072-010-9237-8

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  • DOI: https://doi.org/10.1007/s12072-010-9237-8

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