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

  • Masayo Tsukamoto
  • Katsunori ImaiEmail author
  • Yo-ichi Yamashita
  • Yuki Kitano
  • Hirohisa Okabe
  • Shigeki Nakagawa
  • Hidetoshi Nitta
  • Akira Chikamoto
  • Takatoshi Ishiko
  • Hideo Baba
Original Article
  • 26 Downloads

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.

Keywords

Endoscopic surgery Hepatic resection Radiofrequency ablation Hepatocellular carcinoma Milan criteria 

Notes

Compliance with ethical standards

Conflicts of interest

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

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

595_2019_1903_MOESM1_ESM.tif (82 kb)
Supplementary file 1 (83 kb)

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Masayo Tsukamoto
    • 1
  • Katsunori Imai
    • 1
    Email author
  • Yo-ichi Yamashita
    • 1
  • Yuki Kitano
    • 1
  • Hirohisa Okabe
    • 1
  • Shigeki Nakagawa
    • 1
  • Hidetoshi Nitta
    • 1
  • Akira Chikamoto
    • 1
  • Takatoshi Ishiko
    • 1
  • Hideo Baba
    • 1
  1. 1.Department of Gastroenterological Surgery, Graduate School of Life SciencesKumamoto UniversityKumamotoJapan

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