Propensity score‐matched comparison of non‐anatomical resection and radiofrequency ablation for hepatocellular carcinoma in patients with up to three tumours, each measuring up to 3 cm in diameter. Issue 4 (28th May 2018)

• Record Type: Journal Article
• Authors: Kato, Y.; Okamura, Y.; Omae, K.; Sugiura, T.; Ito, T.; Yamamoto, Y.; Ashida, R.; Sato, R.; Aramaki, T.; Uesaka, K.
• Is Part Of: BJS open. Volume 2:Issue 4(2018)
• Page Start: 213
• Page End: 219
• Publication Date: 2018-05-28
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1002/bjs5.60
• Languages: English
• ISSNs: 2474-9842

Abstract

Abstract : Background: Non‐anatomical liver resection (NAR) and radiofrequency ablation (RFA) are treatment options for early‐stage hepatocellular carcinoma (HCC). The aim was to compare the outcomes of NAR and RFA for HCC in patients with three or fewer tumour nodules, each measuring not more than 3 cm in maximum diameter. Methods: Eligible patients undergoing NAR or RFA with curative intent between September 2002 and December 2014 were identified. A propensity score‐matching analysis was performed to reduce bias, and outcomes in these patients were analysed. Results: From a total of 199 patients, 1:1 propensity score matching identified 70 matched pairs. Patients having NAR had a longer hospital stay (median 10 days versus 4 days for those who had RFA; P < 0·001) and a higher morbidity rate (24 versus 10 per cent respectively; P = 0·042). Patients who had NAR had slightly better recurrence‐free survival but this failed to reach statistical significance in univariable analysis ( P = 0·064). There was no significant difference in overall survival between the two groups ( P = 0·475). RFA was identified as an independent risk factor for recurrence‐free survival (hazard ratio (HR) 1·57; P = 0·041) in multivariable analysis. Local recurrence was significantly more common in patients receiving RFA (23 versus 1 per cent; P < 0·001). Conclusion: RFA was an independent risk factor for shorter recurrence‐free survival, with a significantly higher local recurrence rate than NAR. Despite these differences, overall survival was not affected. Abstract : The aim was to compare the outcomes of non‐anatomical liver resection (NAR) and radiofrequency ablation (RFA) for early‐stage hepatocellular carcinoma (HCC). A propensity score matching analysis was performed to reduce the influence of potential bias by indication. RFA resulted in an independent risk factor for recurrence‐free survival, with significantly higher local recurrence rate than NAR. However, NAR did not improve overall survival in comparison to RFA. Each treatment has its merits