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ORIGINAL ARTICLE

Impact of resection versus radiofrequency ablation on medium-sized hepatocellular Carcinomas: Long-term outcome and prognostic factors


1 Department of Internal Medicine, Division of Gastroenterology and Hepatology, Taichung Armed Forces General Hospital, Taichung; Department of Internal Medicine, Division of Gastroenterology and Hepatology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
2 Department of Surgery, Division of General Surgery, National Defense Medical Center, Tri-Service General Hospital; Department of Surgery, Division of Liver Transplant, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
3 National Defense Medical Center, School of Public Health, Taipei, Taiwan
4 National Defense Medical Center, School of Pharmacy, Taipei, Taiwan
5 Department of Internal Medicine, Division of Gastroenterology and Hepatology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan

Correspondence Address:
Kuo-Feng Hsu,
National Defense Medical Center, Tri-Service General Hospital, No. 325, Sec. 2 Cheng-Kung Road, Neihu 114, Taipei
Taiwan
Yu-Chen Tseng,
National Defense Medical Center, Tri-Service General Hospital, No. 325, Sec. 2 Cheng-Kung Road, Neihu 114, Taipei
Taiwan
Yu-Lueng Shih,
National Defense Medical Center, Tri-Service General Hospital, No. 325, Sec. 2 Cheng-Kung Road, Neihu 114, Taipei
Taiwan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmedsci.jmedsci_366_20

Background: Liver resection (LR) is considered the main therapeutic strategy for small hepatocellular carcinomas (HCCs) (<3 cm). Recently, the efficacy of complete response after radiofrequency ablation (RFA) in medium-sized HCCs (3–5 cm) has been proposed. Comparative analyses of LR and RFA in HCC patients with single or multiple nodules and tumor sizes ranging from 3 to 5 cm are lacking. Aim: The purpose of this study is to compare the long-term outcomes of 132 patients diagnosed with medium-sized HCCs between 2010 and 2017 who underwent LR (n = 72) or RFA (n = 60) and met the inclusion criteria. Materials and Methods: Data were retrospectively analyzed using a prospective database. The treatment-related outcomes and risk factors of overall survival (OS) and disease-free survival (DFS) were investigated using univariate and multivariate Cox regression analyses. Results: The hospital stay was shorter in the RFA group than in the LR group (5.4 days vs. 14.3 days, respectively; P < 0.0001). RFA was associated with fewer treatment-related complications. OS and DFS were better in the LR group than in the RFA group. Treatment modality and albumin and alpha-fetoprotein levels were predictors for OS, while treatment modality and tumor number were predictors for DFS. Conclusions: LR is an effective treatment for patients with medium-sized HCCs in terms of long-term outcomes (OS and DFS), while RFA may be used as an alternative treatment to LR with comparable OS.


 

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