Radiofrequency ablation versus surgical resection for the treatment of hepatocellular carcinoma in cirrhosis.

Autor: Guglielmi, Alfredo, Ruzzenente, Andrea, Valdegamberi, Alessandro, Pachera, Silvia, Campagnaro, Tommaso, D'Onofrio, Mirko, Martone, Enrico, Nicoli, Paola, Iacono, Calogero
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Zdroj: Journal of Gastrointestinal Surgery; Jan2008, Vol. 12 Issue 1, p192-198, 7p, 5 Charts
Abstrakt: Background and Aims: Percutaneous radiofrequency ablation (RFA) demonstrated good results for the treatment of hepatocellular carcinoma (HCC) in cirrhotic patients; it is still not clear whether the overall survival and disease-free survival after RFA are comparable with surgical resection. The aims of this study are to compare the overall survival and disease-free survival in two groups of cirrhotic patients with HCC submitted to surgery or RFA.Methods: Two hundred cirrhotic patients with HCCs smaller than 6 cm were included in this retrospective study: 109 underwent RFA and 91 underwent surgical resection at a single Division of Surgery of University of Verona.Results: Median follow-up time was 27 months. Overall survival was significantly longer in the resection group in comparison with the RFA group with a median survival of 57 and 28 months, respectively (P=0.01). In Child-Pugh class B patients and in patients with multiple HCC, survival was not significantly different between the two groups. In patients with HCC smaller than 3 cm, the overall survival and disease-free survival for RFA and resection were not significantly different in univariate and multivariate analysis. Whereas in patients with HCC greater than 3 cm, surgery showed improvement in outcome in both univariate and multivariate analysis.Conclusions: Surgical resection significantly improves the overall survival and disease-free survival in comparison with RFA. In a selected group of patients (Child-Pugh class B, multiple HCC, or in HCC
Databáze: Complementary Index
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