Radiofrequency ablation compared to resection in early‐stage hepatocellular carcinoma

Abstract

ObjectivesThis study aimed to compare survival outcomes after hepatic resection (HR) and radiofrequency ablation (RFA) in early‐stage hepatocellular carcinoma (HCC) at a Western hepatobiliary centre. MethodsDemographic details, clinicopathologic tumour characteristics and survival outcomes were compared among non‐transplant candidate patients undergoing HR (n= 50) and RFA (n= 60) for early‐stage HCC during 2001–2011. ResultsPatients who underwent HR had larger tumours, a longer length of stay and a higher rate of postoperative complications. After a median follow‐up of 29 months, there were no significant differences between the treatment groups in 1‐, 3‐ and 5‐year overall survival (OS) [RFA group: 86%, 50%, 35%, respectively; HR group: 88%, 68%, 47%, respectively (P= 0.222)] or disease‐free survival (DFS) [RFA group: 68%, 42%, 28%, respectively; HR group: 66%, 42%, 34%, respectively (P= 0.823)]. The 58 patients who underwent RFA demonstrated ablation success on follow‐up computed tomography at 3 months. Of these, 96.5% of patients showed sustained ablation success over the entire follow‐up period. In a subgroup analysis of patients with tumours measuring 2–5 cm, no differences in OS or DFS emerged between the HR and RFA groups. Similarly, no significant differences in outcomes in patients with Child–Pugh class A cirrhosis were seen between the RFA and HR groups. conclusionsRadiofrequency ablation is comparable with HR in terms of OS and DFS. It is a reasonable alternative as a first‐line treatment for HCC in well‐selected patients who are not candidates for transplant.