Comparison of percutaneous cryosurgery and surgical resection for the treatment of small hepatocellular carcinoma.

Abstract

The present study aimed to compare the outcome of percutaneous cryosurgery (PC) with surgical resection (SR) in the treatment of solitary, small hepatocellular carcinoma (HCC), by performing a retrospective cohort study on 82 patients with solitary HCCs who had received either PC (24 patients) or SR (58 patients). All patients underwent pretreatment blood chemistry tests and an imaging evaluation and were regularly followed up with blood and radiological tests following treatment at The Third Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China. The primary endpoint was overall survival (OS) and the secondary endpoints were those of recurrence-free survival (RFS) and adverse events. In the study, the one-, three- and five-year OS rates following surgery were 100, 75.00 and 66.67%, respectively, in the PC group, and 100, 77.59 and 70.69%, respectively, in the SR group. The corresponding RFS rates at one, three and five years after PC and SR were 83.33, 45.83 and 29.17%, respectively, in the PC group and 84.48, 48.28 and 32.76%, respectively, in the SR group. There were no significant differences between these two groups in terms of OS and RFS. There were also no significant differences between the two groups in terms of OS and RFS when comparing the patients with liver cirrhosis (LC) in the PC group (n=16) and the patients with LC (n=39) in the SR group. No significant factors were identified in the multivariate analysis of the risk factors contributing to OS and RFS. Although there were no statistically significant differences between the two groups in terms of the rate of serious adverse events (P=0.82), the incidence of serious adverse events in the SR group was noticeably higher compared with the PC group. Moreover, the duration of hospitalization in the SR group was significantly longer compared with the PC group (P<0.01). These results suggested that PC is as effective as SR in the treatment of solitary, small HCC, while being less invasive, with a shorter duration of hospitalization and a reduction in patient expenditure compared with SR. Thus, PC may be the first choice for the treatment of solitary, small HCC.