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Single HCC smaller than 2 cm: surgery or ablation?
Author(s) -
Takayama Tadatoshi,
Makuuchi Masatoshi,
Hasegawa Kiyoshi
Publication year - 2010
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-009-0239-7
Subject(s) - medicine , radiofrequency ablation , hepatocellular carcinoma , resection , overall survival , surgery , ablation , gastroenterology , liver cancer , carcinoma
Purpose For hepatocellular carcinoma (HCC), surgical resection and radiofrequency ablation (RFA) are accepted as effective treatments. To clarify the long‐term outcome in patients with small HCC, we analyzed data from a nationwide survey of Japan. Methods Between 2000 and 2003, a total of 2,550 patients who had undergone resection ( n = 1,235) or RFA ( n = 1,315) for single small HCC (≤2 cm) were registered to the database of the Liver Cancer Study Group of Japan (LCSGJ). Results After a median follow‐up period of 37 months, disease‐free survival after resection was significantly better than after RFA (1‐year, 91 vs. 87%; 2‐year, 46 vs. 25%; P = 0.001), but overall survival after resection and RFA were similar (98 vs. 99%; 94 vs. 95%, P = 0.28). In the patients of Child–Pugh class A, disease‐free survival was significantly better after resection ( n = 1,056) than after RFA ( n = 965) ( P = 0.001), while overall survival was not significantly different ( P = 0.16). In the patients of Child–Pugh class B, both disease‐free and overall survival were almost similar ( P = 0.63 and P = 0.66) after resection ( n = 136) and RFA ( n = 303). Conclusions For single small HCC (≤2 cm), surgical resection provides better disease‐free survival than does RFA. Longer follow‐up is needed to regard this indication as conclusive.