Laparoscopic liver resection versus percutaneous radiofrequency ablation for small hepatocellular carcinoma
| Autor: | Shinji Uemoto, Satoshi Ogiso, Yuji Eso, Takamichi Ishii, Tomoaki Yoh, Satoru Seo, Shinya Okumura, Takayuki Kawai, Kojiro Taura, Ken Fukumitsu, Hiroshi Seno |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Percutaneous Carcinoma Hepatocellular Radiofrequency ablation Less invasive Resection law.invention 03 medical and health sciences 0302 clinical medicine law medicine Hepatectomy Humans Retrospective Studies Radiofrequency Ablation Hepatology business.industry Incidence (epidemiology) Liver Neoplasms Gastroenterology medicine.disease surgical procedures operative Treatment Outcome 030220 oncology & carcinogenesis Hepatocellular carcinoma Catheter Ablation 030211 gastroenterology & hepatology Laparoscopy Radiology Neoplasm Recurrence Local business Hospital stay Methods treatment |
| Zdroj: | HPB : the official journal of the International Hepato Pancreato Biliary Association. 23(4) |
| ISSN: | 1477-2574 |
| Popis: | Background Laparoscopic liver resection (LLR) and radiofrequency ablation (RFA) play central roles to treat early-stage hepatocellular carcinoma (HCC, ≤3 cm, 1–3 nodules, and no macrovascular involvement), although data are lacking regarding whether LLR or RFA is preferable. This study aimed to compare outcomes of both treatments for small HCCs. Methods Treatment outcomes of small HCCs were compared between all the minor LLRs performed between 2005 and 2016 and RFAs performed between 2011 and 2016 at Kyoto University. Results A total of 85 and 136 patients underwent LLR and RFA, respectively. Patients that underwent LLR had higher incidence of blood transfusions, complications, and longer hospital stay. Overall and disease-specific survival rates were similar between LLR and RFA; however, recurrence-free (49.2% vs. 22.1% at 3-year) and local recurrence-free survival rates (94.9% vs. 63.6% at 3-year) were higher after LLR. Multivariate analyses identified that multiple nodules and 65-year-old and above are predictors of disease-specific survival, and that RFA is a predictor of recurrence and local recurrence. Conclusion RFA is less invasive, although both LLR and RFA are safe and effective. LLR provides better local control with superior recurrence-free and local-recurrence free survival. These results help optimize treatment selection based on patient-specific factors. |
| Databáze: | OpenAIRE |
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