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Endoscopic hepatic resection and endoscopic radiofrequency ablation as initial treatments for hepatocellular carcinoma within the Milan criteria

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Abstract

Purposes

The indication of endoscopic (laparoscopic and thoracoscopic) hepatic resection (HR) has been expanded in the past decade because of its low invasiveness. However, the indications of endoscopic HR and radiofrequency ablation (RFA) have not yet been determined.

Methods

Among the 906 patients hospitalized for the initial treatment of hepatocellular carcinoma (HCC) between 2000 and 2017, 77 underwent endoscopic partial HR (E-pHR), and 94 underwent endoscopic RFA (E-RFA). We compared the short- and long-term outcomes between the E-pHR and E-RFA groups.

Results

The patients in the E-RFA group were characterized primarily by an impaired liver function. Among the patients with liver damage B or C, the overall survival (OS) in the E-pHR group was significantly worse than in the E-RFA group (3-year OS: 36% vs. 82%, p = 0.003).

Conclusion

E-RFA may be recommended for the initial treatment of HCC in patients with a severely impaired liver function. However, E-pHR should be avoided as the initial treatment of HCC in such patients.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan

    Masayo Tsukamoto, Katsunori Imai, Yo-ichi Yamashita, Yuki Kitano, Hirohisa Okabe, Shigeki Nakagawa, Hidetoshi Nitta, Akira Chikamoto, Takatoshi Ishiko & Hideo Baba

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  1. Masayo Tsukamoto
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  2. Katsunori Imai
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  3. Yo-ichi Yamashita
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Correspondence to Katsunori Imai.

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Masayo Tsukamoto and co-authors declare that we have no conflicts of interest.

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Tsukamoto, M., Imai, K., Yamashita, Yi. et al. Endoscopic hepatic resection and endoscopic radiofrequency ablation as initial treatments for hepatocellular carcinoma within the Milan criteria. Surg Today 50, 402–412 (2020). https://doi.org/10.1007/s00595-019-01903-9

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  • DOI: https://doi.org/10.1007/s00595-019-01903-9

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