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Comparison of long‐term effectiveness and complications of radiofrequency ablation with hepatectomy for small hepatocellular carcinoma
Author(s) -
Fang Yong,
Chen Wei,
Liang Xiao,
Li Da,
Lou HaiZhou,
Chen Renbiao,
Wang Kaifeng,
Pan HongMing
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12441
Subject(s) - medicine , hepatectomy , hepatocellular carcinoma , radiofrequency ablation , percutaneous , liver function , surgery , percutaneous ethanol injection , gastroenterology , ablation , resection
Background and Aim To determine and compare the adverse events and long‐term effectiveness for patients with small hepatocellular carcinoma ( HCC ) (≤ 3 cm) treated by percutaneous radiofrequency ablation ( RFA ) or hepatectomy. Methods Small HCC from 120 patients were randomized into either percutaneous RFA therapy or hepatectomy group, and the effectiveness and complications of two treatment modalities were analyzed. The complications of post‐ RFA or hepatectomy, the complete treatment rate, treatment‐related mortality, and disease‐free and overall survival rate were followed up and conducted. Results In patients with small HCC , complete remission rates were achieved in 95% and 96.7% in the percutaneus RFA and hepatectomy groups, respectively ( P > 0.05). Hepatic function at day‐7 status post‐treatment, including albumin and bilirubin levels, were significantly worse in the hepatectomy group ( P < 0.01). Compared with the RFA group, the incidence of postoperative complications (27.5% vs 5.0%) and hospital stay (11.8 ± 3.1 vs 4.3 ± 1.5) were significantly higher in the hepatectomy group ( P < 0.01). After a mean follow‐up of 40 months, 22 patients (36.6%) in the RFA group and 21 patients (35.0%) in the hepatectomy group developed a recurrence ( P > 0.05 ). There was no significant difference of the disease‐free and overall survival rates at 1, 2, and 3 years between the RFA group and the surgical hepatectomy group ( P = 0.443 and P = 0.207, respectively). Conclusions In patients with small HCC , percutaneous RFA showed similar local control and long‐term survival compared with hepatectomy. Importantly, percutaneous RFA are accompanied with a lower complication rate and shorter hospital stay day.