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Comparison of Hepatic Resection with Percutaneous Ablation for Hepatocellular Carcinoma in the Caudate Lobe Within Milan Criteria

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Journal of Gastrointestinal Surgery

Abstract

Purpose

We aimed to compare the efficacy of hepatic resection and percutaneous ablation for resectable caudate HCC within Milan criteria and to investigate the prognostic factors.

Methods

Between August 2006 and August 2020, a total of 67 eligible patients with resectable caudate HCC within Milan criteria in three centers were retrospectively analyzed and divided into hepatic resection group (n = 46) and percutaneous ablation group (n = 21). Recurrence-free survival (RFS) and overall survival (OS) rates were compared between groups of hepatic resection and percutaneous ablation for these resectable caudate HCC patients with Kaplan–Meier curves and log-rank test. Univariable and multivariable Cox regression analyses were performed to identify the prognostic factors of RFS and OS.

Results

The 1-, 3-, and 5-year OS rates were 97.6%, 83.6%, and 71.5% for the hepatic resection group, and 89.4%, 58.5%, and 48.8% for the percutaneous ablation group (P = 0.032). The corresponding RFS rates were 77.6%, 47.9%, and 42.6% for the hepatic resection group, and 40.5%, 23.2%, and 15.4% for the percutaneous ablation group (P = 0.010). According to the univariable and multivariable analyses, tumor type (first recurrence) (HR = 3.54; 95%CI, 1.49–8.37; P = 0.004) was a significant independent prognostic factor of RFS for caudate HCC patients after resection or ablation, while total bilirubin (HR = 1.02; 95%CI, 1.01–1.04; P = 0.006) and treatment strategy (HR = 5.97; 95%CI, 1.48–24.12; P = 0.012) were significant independent prognostic factors of OS.

Conclusions

Hepatic resection appears to outperform percutaneous ablation for caudate HCC patients within Milan criteria.

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Funding

The article is supported by the National Science Fund for Distinguished Young Scholars (No. 81825013), the National Natural Science Foundation of China (No. 82003105), the National Natural Science Foundation of China (No. 81801703), and the Natural Science Foundation of Guangdong, China (No. 2018A030310326).

Author information

Author notes

  1. Wenxuan Xie and Jiehui Tan contributed equally to this work.

Authors and Affiliations

  1. Center of Hepato-Pancreato-Biliary Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China

    Wenxuan Xie & Ming Kuang

  2. Organ Transplant Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China

    Jiehui Tan

  3. Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China

    Bin Li

  4. Division of Interventional Ultrasound, Department of Medical Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China

    Shuling Chen, Baoxian Liu & Ming Kuang

  5. Department of Medical Imaging, Sun Yat-Sen University Cancer Center, Guangzhou, China

    Jingxian Shen

  6. Department of Hepatobiliary Surgery II, Zhujiang Hospital, Southern Medical University, Guangzhou, China

    Shunjun Fu

  7. Department of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan Road 2, Guangzhou, 510080, People’s Republic of China

    Kaiyu Sun

  8. Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan Road 2, Guangzhou, 510080, People’s Republic of China

    Xuezhen Zeng

  9. Department of Pharmacy, The First Affiliated Hospital, Sun Yat-Sen University, No.58, Zhongshan Road 2, Guangzhou, 510080, People’s Republic of China

    Xuezhen Zeng

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  1. Wenxuan Xie
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Correspondence to Kaiyu Sun or Xuezhen Zeng.

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Xie, W., Tan, J., Li, B. et al. Comparison of Hepatic Resection with Percutaneous Ablation for Hepatocellular Carcinoma in the Caudate Lobe Within Milan Criteria. J Gastrointest Surg 26, 323–332 (2022). https://doi.org/10.1007/s11605-021-05111-0

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