Small masses (≤3 cm) diagnosed as hepatocellular carcinoma on pre-treatment imaging: comparison of therapeutic outcomes between hepatic resection and radiofrequency ablation

• Published in: British journal of radiology 2020-01, Vol.93 (1105), p.20190719-20190719
• Main Authors: Cha, Dong Ik, Song, Kyoung Doo, Kang, Tae Wook, Lee, Min Woo, Rhim, Hyunchul
• Format: Article
• Language: English
• Subjects: Biomarkers, Tumor - blood; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - surgery; Contrast Media; Female; Hepatectomy; Humans; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - surgery; Magnetic Resonance Imaging; Male; Middle Aged; Radiofrequency Ablation; Retrospective Studies; Tomography, X-Ray Computed
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr.20190719

To compare therapeutic outcomes between hepatic resection (HR) and radiofrequency ablation (RFA) for small hepatic masses diagnosed as hepatocellular carcinoma (HCC) on pre-treatment imaging study. Our institutional review board approved this retrospective study, and informed consent was waived. Patients with a single ( 3 cm) mass diagnosed as HCC on pre-treatment imaging study between January 2008 and December 2009 who underwent HR ( = 145) or RFA ( = 178) were included. Recurrence-free survival (RFS) and overall survival (OS) were assessed. In the HR group, the false-positive rate for imaging diagnosis was calculated. For the RFA group, the local tumor progression rate was calculated. RFS rates at 5 years were 59.3% for the HR group and 32.2% for the RFA group. OS rates at 5 years were 85.4% for the HR group and 76.8% for the RFA group. In the RFA group, cumulative local tumor progression rates were 8.3 and 20.2% at 1 and 3 years. Treatment modality was not an independent prognostic factor for either RFS or OS on multivariate analysis. The false-positive rate for HCC diagnosis based on imaging criteria was 4.8% in the HR group. The imaging criteria for diagnosis of HCC have a high positive predictive value. Multivariate analysis showed that RFS and OS rates were not significantly different between HR and RFA for small hepatic masses diagnosed as HCC on pre-treatment imaging. Treatment modality (hepatic resection RFA) was not an independent prognostic factor for both RFS and OS for small masses (≤3 cm) diagnosed as hepatocellular carcinoma on pre-treatment imaging.