A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria
- PMID: 21107100
- DOI: 10.1097/SLA.0b013e3181efc656
A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria
Abstract
Objective: To compare the long-term outcomes of surgical resection and radiofrequency ablation for the treatment of small hepatocellular carcinoma (HCC).
Summary background data: Radiofrequency ablation (RFA) is a promising, emerging therapy for small HCC. Whether it is as effective as surgical resection (RES) for long-term outcomes is still indefinite.
Methods: Two hundred thirty HCC patients who met the Milan criteria and were suitable to be treated by either RES or RFA entered into a randomized controlled trial. The patients were regularly followed up after treatment for 5 years (except for those who died). The primary end point was overall survival; the secondary end points were recurrence-free survival, overall recurrence, and early-stage recurrence.
Results: The 1-, 2-, 3-, 4- and 5-year overall survival rates for the RFA group and the RES group were 86.96%, 76.52%, 69.57%, 66.09%, 54.78% and 98.26%, 96.52%, 92.17%, 82.60%, 75.65%, respectively. The corresponding recurrence-free survival rates for the 2 groups were 81.74%, 59.13%, 46.08%, 33.91%, 28.69% and 85.22%, 73.92%, 60.87%, 54.78%, 51.30%, respectively. Overall survival and recurrence-free survival were significantly lower in the RFA group than in the RES group (P = 0.001 and P = 0.017). The 1-, 2-, 3-, 4-, and 5-year overall recurrence rates were 16.52%, 38.26%, 49.57%, 59.13%, and 63.48% for the RFA group and 12.17%, 22.60%, 33.91%, 39.13%, and 41.74% for the RES group. The overall recurrence was higher in the RFA group than in the RES group (P = 0.024).
Conclusions: Surgical resection may provide better survival and lower recurrence rates than RFA for patients with HCC to the Milan criteria.
Comment in
-
Radiofrequency ablation leads to excellent local tumor control and durable longterm survival in specific subsets of early stage HCC patients confirming to the Milan criteria.Ann Surg. 2010 Dec;252(6):913-4. doi: 10.1097/SLA.0b013e3182034862. Ann Surg. 2010. PMID: 21107101 No abstract available.
-
A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria.Ann Surg. 2011 Nov;254(5):837; author reply 837-8. doi: 10.1097/SLA.0b013e318235e4eb. Ann Surg. 2011. PMID: 21997808 No abstract available.
-
A randomized trial comparing radiofrequency ablation and surgical resection for HCC conforming to the Milan criteria.Ann Surg. 2011 Nov;254(5):838-9; author reply 839. doi: 10.1097/SLA.0b013e318235e511. Ann Surg. 2011. PMID: 21997810 No abstract available.
Similar articles
-
Radiofrequency ablation versus hepatic resection for hepatocellular carcinoma within the Milan criteria--a comparative study.Int J Surg. 2013;11(1):77-80. doi: 10.1016/j.ijsu.2012.11.019. Epub 2012 Dec 6. Int J Surg. 2013. PMID: 23220487
-
Clinical outcomes of radiofrequency ablation and surgical resection for small hepatocellular carcinoma: a meta-analysis.J Gastroenterol Hepatol. 2012 Jan;27(1):51-8. doi: 10.1111/j.1440-1746.2011.06947.x. J Gastroenterol Hepatol. 2012. PMID: 22004366 Review.
-
Meta-analysis of the therapeutic effect of hepatectomy versus radiofrequency ablation for the treatment of hepatocellular carcinoma.Surg Laparosc Endosc Percutan Tech. 2010 Jun;20(3):130-40. doi: 10.1097/SLE.0b013e3181d823df. Surg Laparosc Endosc Percutan Tech. 2010. PMID: 20551807 Review.
-
Surgical resection versus radiofrequency ablation for small hepatocellular carcinomas within the Milan criteria.J Hepatobiliary Pancreat Surg. 2009;16(3):359-66. doi: 10.1007/s00534-009-0069-7. Epub 2009 Mar 20. J Hepatobiliary Pancreat Surg. 2009. PMID: 19300896
-
[The comparative results of radiofrequency ablation versus surgical resection for the treatment of hepatocellular carcinoma].Korean J Hepatol. 2005 Mar;11(1):59-71. Korean J Hepatol. 2005. PMID: 15788886 Korean.
Cited by
-
Evaluation of the effectiveness of surgical resection and ablation for the treatment of early-stage hepatocellular carcinoma: A retrospective cohort study.Cancer Rep (Hoboken). 2024 Mar;7(3):e2030. doi: 10.1002/cnr2.2030. Cancer Rep (Hoboken). 2024. PMID: 38488487 Free PMC article.
-
Laparoscopic liver resection is superior to radiofrequency ablation for small hepatocellular carcinoma: a systematic review and meta-analysis of propensity score-matched studies.Hepatol Int. 2024 Jun;18(3):998-1010. doi: 10.1007/s12072-024-10645-x. Epub 2024 Mar 14. Hepatol Int. 2024. PMID: 38480604
-
Locoregional therapies for hepatocellular carcinoma: The current status and future perspectives.United European Gastroenterol J. 2024 Mar;12(2):226-239. doi: 10.1002/ueg2.12554. Epub 2024 Feb 19. United European Gastroenterol J. 2024. PMID: 38372444 Free PMC article. Review.
-
Comparison of liver resection and radiofrequency ablation in long-term survival among patients with early-stage hepatocellular carcinoma: a meta-analysis of randomized trials and high-quality propensity score-matched studies.World J Surg Oncol. 2024 Feb 19;22(1):56. doi: 10.1186/s12957-024-03330-8. World J Surg Oncol. 2024. PMID: 38369480 Free PMC article.
-
Liver resection versus radiofrequency ablation or trans-arterial chemoembolization for early-stage (BCLC A) oligo-nodular hepatocellular carcinoma: meta-analysis.BJS Open. 2024 Jan 3;8(1):zrad158. doi: 10.1093/bjsopen/zrad158. BJS Open. 2024. PMID: 38323881 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Miscellaneous