Comparison of 2 curative treatment options for very early hepatocellular carcinoma: Efficacy, recurrence pattern, and retreatment.

Abstract:

:Curative treatments for very early-stage hepatocellular carcinoma (HCC), defined as single HCC with a maximum diameter of <2 cm in patients with well-preserved liver function, consist of surgical resection or radiofrequency ablation (RFA). In this retrospective study, we compared the efficacy of both treatments in 154 patients with very early-stage HCCs who underwent resection or RFA as initial therapy and were followed up for a median of 56.8 months. Propensity score matching analysis was also conducted. Overall survival was comparable between treatment groups (median survival time of 143 vs 97 months for resection and RFA, respectively; P = .132). Resection group; however, demonstrated a significantly lower recurrence rate after initial therapy than RFA group (42.3% vs 65.7%; P = .006) with a longer median recurrence-free survival time (66.7 vs 33.8 months; P = .002), which was confirmed even after matching (P = .04). In contrast, the recurrence pattern in advanced-stage (9.6% vs 1.0%; P = .01) or incurable recurrences (19% vs 13%; P = .04) was more frequent following resection than RFA. Recurrent lesions were comparatively more curable in RFA group than in resection group (80% vs 54.5%; P = .02). The recurrence of HCC was independently associated with lower serum albumin level (P = .027), the presence of comorbid diabetes mellitus (P = .010), and RFA (P = .034). In conclusion, in patients with very early-stage HCC, surgical resection has achieved significantly better recurrence-free survival than RFA. A closer follow-up is required after resection.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Kim TH,Chang JM,Um SH,Jee H,Lee YR,Lee HA,Yim SY,Han NY,Lee JM,Choi HS,Kim ES,Yu YD,Keum B,Kim MJ,An H,Park BJ,Seo YS,Kim DS,Yim HJ,Cho SB,Jeen YT,Lee HS,Chun HJ,Kim YH,Kim CD

doi

10.1097/MD.0000000000016279

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

e16279

issue

26

eissn

0025-7974

issn

1536-5964

pii

00005792-201906280-00111

journal_volume

98

pub_type

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