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Safety and Efficacy of Radiofrequency Ablation for Solitary Hepatocellular Carcinoma (3–5 cm): a Propensity Score Matching Cohort Study

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

We aim to investigate the safety and efficacy of radiofrequency ablation in the treatment of solitary hepatocellular carcinoma (3–5 cm) in comparison with surgical resection.

Methods

Included in this study were 388 patients with primary and solitary hepatocellular carcinoma, of whom 196 patients underwent surgical resection and the other 192 patients received radiofrequency ablation. Clinicopathological characteristics, prognosis, post-treatment complications, hospital stay, and financial expenditures between the two groups were compared retrospectively.

Results

The result of propensity score matching and subgroup analysis showed that the 1-, 3-, and 5-year overall survival and disease-free survival were comparable in patients with tumors of 3–4 cm in diameter between surgical resection and radiofrequency ablation groups. However, when the tumor size exceeded 4 cm in diameter, surgical resection exhibited a superior long-term prognosis compared with radiofrequency ablation. Nevertheless, hepatectomy was associated with high occurrences of postoperative complications, long hospital stay, and high hospitalization cost as compared with radiofrequency ablation. Further analysis of the relationship between tumor size and pathological features of hepatocellular carcinoma showed that tumors larger than 4 cm were positively correlated with a high rate of microvascular invasion and satellite nodule formation.

Conclusion

For solitary hepatocellular carcinoma of 3–4 cm in diameter, radiofrequency ablation could achieve a comparable prognosis with a low incidence of post-treatment complications and low hospitalization costs, while surgical resection is recommended for solitary hepatocellular carcinoma tumors of 4–5 cm in diameter when long-term prognosis is considered.

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Acknowledgements

Thanks for Dr. Xu Lin’s help (an intervention radiologist) in the description of RFA.

Funding

This study was supported by the General Program of Shanghai Municipal Commission of Health and Family Planning (No. 201440445) and the National Nature Science Foundation of China (No. 81372355).

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Author notes

  1. Qing-wang Ye, Shu-jie Pang and Ning Yang contributed equally to this work.

Authors and Affiliations

  1. Department of Hepatic Surgery, Shanghai Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, 200438, China

    Qing-wang Ye, Shu-jie Pang, Ning Yang, Hai-bin Zhang, Yong Fu & Guang-shun Yang

  2. Department of Hepatic Surgery, Suqian People’s Hospital of Nanjing Drum-Tower Hospital Group, Suqian, 223800, China

    Qing-wang Ye & Bin Lin

Authors
  1. Qing-wang Ye
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  2. Shu-jie Pang
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  6. Bin Lin
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Contributions

Guang-shun Yang, Qing-wang Ye, and Shu-jie Pang designed the project. Qing-wang Ye and Shu-jie Pang wrote the manuscript with Guang-shun Yang. Guang-shun Yang and Lin Bin provided revisions of the manuscript; Yang Ning, Hai-bin Zhang, Fu Yong, and Guang-shunYang collected and assembled the data; Qing-wang Ye, Shu-jie Pang, Lin Bin, and Guang-shun Yang analyzed the data and interpreted results; and all authors have given their final approval for the manuscript.

Corresponding authors

Correspondence to Bin Lin or Guang-shun Yang.

Ethics declarations

Ethics Approval and Consent to Participate

This study complied with the ethical guidelines of the Declaration of Helsinki and was approved by our Ethics Committee of the hospital. Informed consent was obtained from all patients before treatment for their data to be used in this study.

Conflict of Interest

The authors declare that there are no competing interests.

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Flow-diagram for screening of patients enrolled in this study (PNG 255 kb)

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Ye, Qw., Pang, Sj., Yang, N. et al. Safety and Efficacy of Radiofrequency Ablation for Solitary Hepatocellular Carcinoma (3–5 cm): a Propensity Score Matching Cohort Study. J Gastrointest Surg 23, 1549–1558 (2019). https://doi.org/10.1007/s11605-019-04229-6

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  • DOI: https://doi.org/10.1007/s11605-019-04229-6

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