Surgery versus radiofrequency ablation in patients with Child- Pugh class-A/single small (≤3 cm) hepatocellular carcinoma

• Published in: Clinical and molecular hepatology 2022, 28(2), , pp.207-218
• Main Authors: Lee, Jungnam, Jin, Young-Joo, Shin, Seung Kak, Kwon, Jung Hyun, Kim, Sang Gyune, Suh, Young Ju, Jeong, Yujin, Yu, Jung Hwan, Lee, Jin-Woo, Kwon, Oh Sang, Nahm, Soon Woo, Kim, Young Seok
• Format: Article
• Language: English
• Subjects: Ablation; Cancer therapies; Carcinoma, Hepatocellular - surgery; Catheter Ablation; Cohort analysis; Comorbidity; Electrodes; Hepatectomy; hepatocellular carcinoma; Humans; Liver cancer; Liver cirrhosis; Liver Cirrhosis - complications; Liver Neoplasms - surgery; Magnetic resonance imaging; Medical prognosis; Metastasis; Neoplasm Recurrence, Local - surgery; operation; Original; Propensity Score; Radiofrequency Ablation; Retrospective Studies; survival; Treatment Outcome; Tumors; 내과학
• ISSN: 2287-2728; 2287-285X
• DOI: 10.3350/cmh.2021.0294

We compared the post-treatment overall survival (OS) and recurrence-free survival (RFS) between patients with Child-Turcotte-Pugh (CTP) class-A and single small (≤3 cm) hepatocellular carcinoma (HCC) treated by surgical resection (SR) and radiofrequency ablation (RFA). We retrospectively analyzed 391 HCC patients with CTP class-A who underwent SR (n=232) or RFA (n=159) as first-line therapy for single small (≤3 cm) HCC. Survival was compared according to the tumor size (≤2 cm/2-3 cm) and the presence of cirrhosis. Inverse probability of treatment weighting (IPW) method was used to estimate the average causal effect of treatment. The median follow-up period was 64.8 months (interquartile range, 0.1-162.6). After IPW, the estimated OS was similar in the SR and RFA groups (P=0.215), and even in patients with HCC of ≤2 cm (P=0.816) and without cirrhosis (P=0.195). The estimated RFS was better in the SR group than in the RFA groups (P=0.005), also in patients without cirrhosis (P