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Selecting treatment for hepatocellular carcinoma based on the results of hepatic resection and local ablation therapy
Author(s) -
Nanashima Atsushi,
Tobinaga Syuuichi,
Masuda Junichi,
Miyaaki Hisamitsu,
Taura Naota,
Takeshita Hiroaki,
Hidaka Shigekazu,
Sawai Terumitsu,
Nakao Kazuhiko,
Nagayasu Takeshi
Publication year - 2010
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21523
Subject(s) - medicine , hepatocellular carcinoma , hepatectomy , ablation , liver function , surgery , gastroenterology , survival rate , hccs , resection
Background First‐line treatment for ≤3 hepatocellular carcinomas (HCCs) ≤3 cm in size remains controversial. The superiority of survival benefit needs to be clarified between these modalities for such lesions. Methods We examined post‐treatment survival of 144 consecutive HCC patients who underwent hepatectomy and of 56 consecutive HCC patients who underwent thermal ablation therapy limited to the HCC (≤3 cm, ≤3 lesions). Results Pretreatment liver function was significantly worse and prevalence of Child‐Pugh classification B/C was significantly higher in the ablation group compared to the hepatectomy group. Prevalence of tumor recurrence after treatment did not differ significantly between groups, irrespective of solitary or multiple HCC. In solitary HCC, overall survival rates in both groups did not differ significantly. Even in Child‐Pugh B patients, survival was not significantly different between hepatectomy and ablation. In HCC with 2–3 lesions ≤3 cm, overall survival was significantly longer with hepatectomy than with ablation and mean survival periods in the hepatectomy and ablation groups were 4.5 and 1.2 years, respectively. Conclusion In cases of multiple small HCCs, hepatic resection is recommended over local ablation therapy as the first‐line treatment in cases where liver function has been preserved. J. Surg. Oncol. 2010; 101:481–485. © 2010 Wiley‐Liss, Inc.