Comparative analysis of intraoperative radiofrequency ablation versus non-anatomical hepatic resection for small hepatocellular carcinoma: short-term result

Y. Yune, Seokwhan Kim, I. Song, Kwang-Sik Chun
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引用次数: 8

Abstract

Backgrounds/Aims To compare the clinical outcomes of intraoperative radiofrequency ablation (RFA) and non-anatomical hepatic resection (NAHR) for small hepatocellular carcinoma (HCC). Methods From February 2007 to January 2015, clinical outcomes of thirty four patients with HCC receiving RFA or NAHR were compared, retrospectively. Results There was no difference of patient and tumor characteristic between the two groups that received RFA or NAHR. The 1, 2, and 3-year recurrence rates following RFA were 32.2%, 32.2% and 59.3% respectively, and 6.7%, 33.3% and 33.3% following NAHR respectively (p=0.287). The 1, 2 and 3-year overall survival (OS) rates following RFA were 100%, 88.9% and 76.2% respectively, and 100%, 85.6% and 85.6%, respectively, following NAHR (p=0.869). We did not find a definite statistical difference in recurrence rate and OS rate between the two groups. In the multivariate analysis, number of tumor was an independent prognostic factor for recurrence and albumin was an independent prognostic factor for OS. Conclusions We recommend non-anatomical hepatic resection rather than intraoperative RFA in small sized HCC, due to a higher recurrence rate in intraoperative RFA. Intraoperative RFA was inferior to non-anatomical hepatic resection in terms of recurrence rate. We need to select the optimal treatment considering liver function and possibility of recurrence.
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术中射频消融与非解剖性肝切除术治疗小肝癌的近期疗效比较分析
背景/目的比较术中射频消融(RFA)与非解剖性肝切除术(NAHR)治疗小肝细胞癌的临床疗效。方法回顾性比较2007年2月至2015年1月34例HCC患者接受RFA或NAHR治疗的临床结果。结果RFA组与NAHR组患者及肿瘤特征无明显差异。RFA术后1、2、3年复发率分别为32.2%、32.2%、59.3%,NAHR术后1、2、3年复发率分别为6.7%、33.3%、33.3% (p=0.287)。RFA术后1、2、3年总生存率分别为100%、88.9%、76.2%,NAHR术后1、2、3年总生存率分别为100%、85.6%、85.6% (p=0.869)。两组的复发率和总生存率没有明显的统计学差异。在多因素分析中,肿瘤数目是复发的独立预后因素,白蛋白是OS的独立预后因素。结论我们推荐非解剖性肝切除术,而不是术中射频消融治疗小肝癌,因为术中射频消融的复发率更高。术中RFA的复发率低于非解剖性肝切除术。我们需要考虑肝功能和复发的可能性来选择最佳的治疗方法。
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