Open AccessSurvival Analysis of Re‐resection Versus Radiofrequency Ablation for Intrahepatic Recurrence After Hepatectomy for Hepatocellular Carcinoma
Author(s) -
Chan Albert C. Y.,
Poon Ronnie T. P.,
Cheung Tan To,
Chok Kenneth S. H.,
Chan See Ching,
Fan Sheung Tat,
Lo Chung Mau
Publication year - 2012
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-011-1323-0
Subject(s) - medicine , hepatocellular carcinoma , radiofrequency ablation , hepatectomy , surgery , resection , abdominal surgery , ablation
Background Tumor recurrence after resection of hepatocellular carcinoma is a common phenomenon. Re‐resection and radiofrequency ablation (RFA) are good options for treating recurrent HCC. This study compared the efficacy of these two modalities in the treatment of intrahepatic HCC recurrence after hepatectomy. Methods From January 2001 to December 2008, a total of 179 patients developed intrahepatic HCC recurrence after hepatectomy. To treat the recurrence, 29 patients underwent re‐resection and 45 patients had RFA. Patient characteristics, clinicopathologic data, and survival outcomes were reviewed. Results Child‐Pugh status, time to develop first recurrence (12.2 vs. 8.7 months), and recurrent tumor size (2.1 vs. 2.1 cm) were comparable for the two groups. Time to develop a second intrahepatic recurrence after re‐resection and RFA was 5.9 and 4.0 months respectively. The 1‐, 3‐, and 5‐year disease‐free survival rates were 41.4%, 24.2%, and 24.2% after re‐resection and 32.2%, 12.4%, and 9.3% after RFA ( p = 0.14). The 1‐, 3‐, and 5‐year overall survival rates were 89.7%, 56.5%, and 35.2% after re‐resection and 83.7%, 43.1%, and 29.1% after RFA ( p = 0.48). For the second recurrence, 33.3% of patients underwent a second round of RFA and 10.0% underwent a third resection. Conclusions The two treatment modalities attained similar survival benefits in the management of recurrent HCC after hepatectomy. The high repeatability of RFA and that it can be delivered percutaneously render it a preferred treatment option for selected patients.