Open AccessSurgery versus Radiofrequency Ablation for Small Hepatocellular Carcinoma: A Randomized Controlled Trial (SURF Trial)
Author(s) -
Takayama Tadatoshi,
Hasegawa Kiyoshi,
Izumi Namiki,
Kudo Masatoshi,
Shimada Mitsuo,
Yamanaka Naoki,
Inomata Masafumi,
Kaneko Shuichi,
Nakayama Hisashi,
Kawaguchi Yoshikuni,
Kashiwabara Kosuke,
Tateishi Ryosuke,
Shiina Shuichiro,
Koike Kazuhiko,
Matsuyama Yutaka,
Omata Masao,
Makuuchi Masatoshi,
Kokudo Norihiro
Publication year - 2021
Publication title -
liver cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.916
H-Index - 34
eISSN - 1664-5553
pISSN - 2235-1795
DOI - 10.1159/000521665
Subject(s) - research article
It remains unclear which surgery or radiofrequency ablation (RFA) is the more effective treatment for small hepatocellular carcinoma (HCC). We aimed to compare survival between patients undergoing surgery (surgery group) and patients undergoing RFA (RFA group). Methods: We conducted a randomized controlled trial involving 49 institutions in Japan. Patients with Child-Pugh scores ≤7, largest HCC diameter ≤3 cm, and ≤3 HCC nodules were considered eligible. The co-primary endpoints were recurrence-free survival (RFS) and overall survival (OS). The current study reports the final result of RFS, and the follow-up of OS is still ongoing. Results: During 2009–2015, 308 patients were registered. After excluding ineligible patients, the surgery and RFA groups included 150 and 151 patients, respectively. Baseline factors did not differ significantly between the groups. In both groups, 90% of patients had solitary HCC. The median largest HCC diameter was 1.8 cm (interquartile range [IQR], 1.5–2.2 cm) in the surgery group and 1.8 cm (IQR, 1.5–2.3 cm) in the RFA group. The median procedure duration (274 vs. 40 min, p < 0.01) and the median duration of hospital stay (17 days vs. 10 days, p < 0.01) were longer in the surgery group than in the RFA group. RFS did not differ significantly between the groups as the median RFS was 3.5 (95% confidence interval [CI], 2.6–5.1) years in the surgery group and 3.0 (95% CI, 2.4–5.6) years in the RFA group (hazard ratio, 0.92; 95% CI, 0.67–1.25; p = 0.58). Discussion/Conclusion: Our study did not show which surgery or RFA is the better treatment option for small HCC.