Radiofrequency ablation versus liver resection and liver transplantation for small combined hepatocellular-cholangiocarcinoma stratified by tumor size.
Langenbecks Arch Surg
; 408(1): 119, 2023 Mar 15.
Article
in En
| MEDLINE
| ID: mdl-36918430
ABSTRACT
PURPOSE:
Although radiofrequency ablation (RFA) has been proven to provide a good survival benefit for small hepatocellular carcinoma (HCC), there is limited information about RFA for combined hepatocellular-cholangiocarcinoma (cHCC-CC). The purpose of this study was to explore the clinicopathological features of cHCC-CC and the curative effect of RFA in small cHCC-CC without distant metastases compared with liver resection (LR) and liver transplantation (LT).METHODS:
Patients with cHCC-CC, intrahepatic cholangiocarcinoma, or HCC were identified in the Surveillance, Epidemiology, and End Results database.RESULTS:
cHCC-CC had the highest rate of poor pathological grade and the lowest rate of bone metastases compared with intrahepatic cholangiocarcinoma and HCC (all P < 0.05). In patients with cHCC-CC after surgery, multivariate analysis showed that compared with RFA, LR and LT were independent protective factors for survival (all P < 0.05). But in cHCC-CC stratified by tumor size, for tumor size ≤ 3.0 cm, there was no significant difference among RFA, LR, and LT in univariate survival analysis (P = 0.285). For tumor size 3.0-5.0 cm, multivariate analysis showed that RFA for cHCC-CC yielded worse survival outcomes in comparison with that of LR (hazard ratio [HR] 7.51, 95% confidence interval [CI] 2.09-26.94, P = 0.002) and LT (HR 4.48, 95% CI 1.20-16.64, P = 0.025).CONCLUSIONS:
In patients with cHCC-CC without distant metastases, for tumor size ≤ 3.0 cm, there was no significant survival difference among RFA, LR, and LT. However, for tumor size 3.0-5.0 cm, RFA may provide a worse survival benefit than LT and LR.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Bile Duct Neoplasms
/
Liver Transplantation
/
Cholangiocarcinoma
/
Carcinoma, Hepatocellular
/
Radiofrequency Ablation
/
Liver Neoplasms
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Langenbecks Arch Surg
Year:
2023
Document type:
Article
Affiliation country:
China