Radiofrequency ablation is an inferior option to liver resection for solitary hepatocellular carcinoma ≤ 5 cm without cirrhosis: A population-based study with stratification by tumor size.
Hepatobiliary Pancreat Dis Int
; 22(6): 605-614, 2023 Dec.
Article
em En
| MEDLINE
| ID: mdl-35977873
ABSTRACT
BACKGROUND:
About 10%-20% of all individuals who develop hepatocellular carcinoma (HCC) do not have cirrhosis. Comparisons are rarely reported regarding the effectiveness of radiofrequency ablation (RFA) and liver resection (LR) in survival of HCC without cirrhosis and stratification by tumor size ≤ 5 cm.METHODS:
We used the Surveillance, Epidemiology, and End Results (SEER) database and identified 1505 patients with a solitary HCC tumor ≤ 5 cm who underwent RFA or LR during 2004-2015. Patients were classified into non-cirrhosis and cirrhosis groups and each group was categorized into three subgroups, according to tumor size (≤ 30 mm, 31-40 mm, 41-50 mm).RESULTS:
In patients without cirrhosis, LR showed better 5-year HCC cancer-specific survival than RFA in all tumor size subgroups (≤ 30 mm 82.51% vs. 56.42%; 31-40 mm 71.31% vs. 46.83%; 41-50 mm 74.7% vs. 37.5%; all P < 0.05). Compared with RFA, LR was an independent protective factor for HCC cancer-specific survival in multivariate Cox analysis [≤ 30 mm hazard ratio (HR) = 0.533, 95% confidence interval (CI) 0.313-0.908; 31-40 mm HR = 0.439, 95% CI 0.201-0.957; 41-50 mm HR = 0.382; 95% CI 0.159-0.916; all P < 0.05]. In patients with cirrhosis, for both tumor size ≤ 30 mm and 31-40 mm groups, there were no significant survival differences between RFA and LR in multivariate analysis (all P > 0.05). However, in those with tumor size 41-50 mm, LR showed significantly better 5-year HCC cancer-specific survival than RFA in both univariate (54.72% vs. 23.06%; P < 0.001) and multivariate analyses (HR = 0.297; 95% CI 0.136-0.648; P = 0.002).CONCLUSIONS:
RFA is an inferior treatment option to LR for patients without cirrhosis who have a solitary HCC tumor ≤ 5 cm.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Ablação por Cateter
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Carcinoma Hepatocelular
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Ablação por Radiofrequência
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Neoplasias Hepáticas
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article