Clinical Research Papers:
Comparison of repeated surgical resection and radiofrequency ablation for small recurrent hepatocellular carcinoma after primary resection
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Wei-Chi Sun1,2,*, I-Shu Chen2,3,*, Huei-Lung Liang1,4, Cheng-Chung Tsai2,3, Yu-Chia Chen2,3, Being-Whey Wang2,3, Huey-Shyan Lin5, Hoi-Hung Chan1,2, Ping-I Hsu1,2, Wei-Lun Tsai1,2 and Jin-Shiung Cheng1,2
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
2Shool of Medicine, National Yang-Ming University, Taipei, Taiwan
3Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
4Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
5School of Nursing, Fooying University, Kaohsiung, Taiwan
*These authors contributed equally to this work
Wei-Lun Tsai, email: [email protected]
Keywords: hepatocellular carcinoma, radiofrequency ablation, resection
Received: April 19, 2017 Accepted: September 20, 2017 Published: October 07, 2017
There is controversy concerning whether radiofrequency ablation (RFA) or surgical resection (SR) is a better treatment option for recurrent HCC after resection. In Kaohsiung Veteran General Hospital, from January 2002 to September 2014, a total of 100 consecutive patients who developed recurrent HCCs with a tumor size ≦ 3 cm and tumor numbers ≦ 3 after surgical resection were enrolled. Among these patients, 57 patients received RFA and 43 patients underwent repeated SR. Baseline characteristics at the time of recurrence after hepatic resection and clinical outcomes following treatment of recurrent HCC were compared between the two groups. The baseline data of initial HCC and the first recurrence of HCC were comparable in both groups. The 1-, 3-, 5-year overall survival rates following treatment of the first recurrence of HCC were 97.6%, 82.7%, 56.4% in the repeated SR group and 98.2%, 77.2%, 52.6% in the RFA group (p = 0.69). The 1-, 3-, 5-year disease-free survival rates were 57.0%, 32.1%, 28.6% in the repeated SR group and 60.8%, 26.6%, 16.6% in the RFA group ((p = 0.89). There was a trend whereby patients who underwent repeated SR had more procedure-related morbidity than patients who underwent RFA (16% vs. 7%, p = 0.14). The median total hospital days were longer in the repeated SR group than that in the RFA group (13 vs. 5 days, p < 0.05). In the small recurrent HCCs after SR, RFA achieved similar overall survival and disease-free survival than those with repeated SR as well as having a shorter hospital stay.
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