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Article: Prospective comparative study of cool-tip radiofrequency ablation and surgical resection for hepatocellular carcinoma[show abstract] [hide abstract]
ABSTRACT: ObjectiveThe aim of this study was to compare the therapeutic efficacy of radiofrequency ablation (RFA) and surgical resection for the patients with hepatocellular carcinoma (HCC). MethodsFrom January 2002 to June 2009, 87 HCC patients with 3 or fewer nodules, no more than 3 cm in diameter, and liver function of Child-Pugh class A or B were enrolled. Forty-seven underwent RFA while 40 underwent surgical resection. Follow-up ranged from 6 to 69 months. We compared the overall and disease-free survival rate, recurrence patterns, and the complications between the two groups. Survival probabilities were estimated using the Kaplan-Meier method. ResultsAt the end of the study, 67 patients were alive. The 1-, 2- and 3-year overall cumulative survival rates after RFA and surgical resection were 91.0%, 76.7%, 69.7% and 90.0%, 82.9%, 75.4%, respectively. The difference between the two survival curves was not statistically significant (χ2 = 0.99, P = 0.32). Forty-three patients suffered intrahepatic recurrence, including 25 cases after RFA and 18 cases after surgical resection. The 1-, 2-, and 3-year disease-free survival rates after radiofrequency ablation and surgical resection were 57.3% vs 71.1%, 40.3% vs 45.7%, and 35.3% vs 30.9%. The difference between the two groups was not statistically significant (χ2 = 0.06, P = 0.80). Cox hazard model indicated tumor size and Child-Pugh scoring were significant risk factors for local tumor progression, while tumor numbers was risk factor for intrahepatic distant recurrence. ConclusionRFA is as effective as surgical resection for the treatment of patients with HCC (≤ 5 cm), especially for those who are not suitable for curative resection. Key wordshepatocellular carcinoma (HCC)–cool-tip radiofrequency ablation (RFA)–hepatectomy–efficacy–recurrenceThe Chinese-German Journal of Clinical Oncology 05/2012; 10(7):399-405.