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Percutaneous Radiofrequency Ablation versus Partial Hepatectomy for Multicentric Small Hepatocellular Carcinomas: A Nonrandomized Comparative Study

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Abstract

Background

The aim of this study was to compare the results of percutaneous radiofrequency ablation (RFA) with those of partial hepatectomy (PH) in the treatment of multicentric small hepatocellular carcinomas (HCCs). With advances in RFA, it is not known whether the minimally invasive approach with percutaneous RFA could attain comparable survival outcomes but with a lower morbidity in patients with multicentric HCCs.

Methods

From January 2002 and December 2007, 159 patients who had two or three HCCs, with the largest tumor no more than 5 cm in diameter, had no major vascular invasion or extrahepatic metastases, and were treated with either PH (n = 73) or RFA (n = 86) were included in the study.

Results

There was no procedure-related mortality in both groups of patients. Major complications happened significantly more often after PH than after RFA (19.2 vs. 8.1%). The hospital stay was significantly longer after PH than after RFA (median = 9 vs. 3 days). The 1-, 3-, and 5-year overall survival rates for the PH and RFA groups were 91.8, 68.7, 44.5% and 94.2, 64.4, 21.2%, respectively. The corresponding disease-free survival rates for the two groups were 62.1, 33.6, 3.6% and 29.4, 2.7, 0%, respectively. The PH group had significantly longer overall survival and disease-free survival than the RFA group.

Conclusions

PH resulted in better survival outcomes than RFA for patients with multicentric small HCCs. However, RFA had the benefits of lower procedure-related morbidity and shorter hospital stay.

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Acknowledgment

This work was supported by grants from The Ministry of Technology Key Program (No. 2008zx10002-025), National Natural Science Foundation (No. 30873352), Shanghai Science and Technology Committee (No. 07JC14066), Shanghai Education Committee of Shuguang Plan (No. 05SG39), and Shanghai Education Committee of Chenguang Plan (No. 2007CG48).

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Authors and Affiliations

  1. Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, No. 225 Changhai Road, 200438, Shanghai, China

    Wei-Xing Guo, Bo Zhai, Eric C. H. Lai, Nan Li, Jie Shi, Wan-Yee Lau, Meng-Chao Wu & Shu-Qun Cheng

  2. Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China

    Wan-Yee Lau

Authors
  1. Wei-Xing Guo
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  2. Bo Zhai
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  3. Eric C. H. Lai
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  4. Nan Li
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  5. Jie Shi
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  6. Wan-Yee Lau
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  7. Meng-Chao Wu
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  8. Shu-Qun Cheng
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Corresponding authors

Correspondence to Wan-Yee Lau or Shu-Qun Cheng.

Additional information

W.-X. Guo and B. Zhai contributed equally to this work.

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Guo, WX., Zhai, B., Lai, E.C.H. et al. Percutaneous Radiofrequency Ablation versus Partial Hepatectomy for Multicentric Small Hepatocellular Carcinomas: A Nonrandomized Comparative Study. World J Surg 34, 2671–2676 (2010). https://doi.org/10.1007/s00268-010-0732-9

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  • DOI: https://doi.org/10.1007/s00268-010-0732-9

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