Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2004 Jul;240(1):102-7.
doi: 10.1097/01.sla.0000129672.51886.44.

Surgical resection versus percutaneous radiofrequency ablation in the treatment of hepatocellular carcinoma on cirrhotic liver

Marco Vivarelli  1 , Alfredo Guglielmi, Andrea Ruzzenente, Alessandro Cucchetti, Roberto Bellusci, Claudio Cordiano, Antonino Cavallari
Affiliations
Comparative Study

Surgical resection versus percutaneous radiofrequency ablation in the treatment of hepatocellular carcinoma on cirrhotic liver

Marco Vivarelli et al. Ann Surg. 2004 Jul.

Abstract

Objective: We sought to compare the experience of 2 different surgical units in the treatment of hepatocellular carcinoma (HCC) on cirrhosis with resection or percutaneous radiofrequency ablation (RFA), respectively.

Summary background data: When allowed by the hepatic functional reserve, surgery is the therapy for HCC on cirrhosis; alternative treatments are proposed because of the high tumor recurrence rate after resection. RFA is being widely adopted to treat HCC.

Methods: Over a 4-year period, 79 cirrhotics with HCC underwent resection in 1 surgical unit (group A) and another 79 had RFA at a different unit (group B). Patient selection, operative mortality, hospital stay, and 1- and 3-year overall and disease-free survival were analyzed.

Results: Group A (surgery): mean follow-up was 28.9 +/- 17.9 months; operative mortality was 3.8%, mean hospital stay 9 days; 1- and 3-year survival were, respectively, 83 and 65%. One- and 3-year disease-free survival were 79 and 50%. Group B (RFA): mean follow-up was 15.6 +/- 11.7 months. Mean hospital stay was 1 day (range 1-8). One- and 3-year survival were 78 and 33%; 1- and 3-year disease-free survival were 60 and 20%. Overall and disease-free survival were significantly higher in group A (P = 0.002 and 0.001). The advantage of surgery was more evident for Child-Pugh class A patients and for single tumors of more than 3 cm in diameter. Results were similar in 2 groups for Child-Pugh class B patients

Conclusions: RFA has still to be confirmed as an alternative to surgery for potentially-resectable HCCs.

PubMed Disclaimer

Figures

None
FIGURE 1. overall survival of all patients in the 2 treatment groups: survival was significantly higher in the resection group (P = 0.002). RFA: radiofrequency ablation.
None
FIGURE 2. overall survival of all Child A patients in the 2 treatment groups: survival was significantly higher in the resection group (P = 0.02). RFA: radiofrequency ablation.
See this image and copyright information in PMC

References

    1. Martin P. Hepatocellular carcinoma: risk factors and natural history. Liver Transpl Surg. 1998;4(Suppl 1):87–91. - PubMed
    1. Bolondi L, Sofia S, Siringo S, et al. Surveillance programme of cirrhotic patients for early diagnosis and treatment of hepatocellular carcinoma: a cost effectiveness analysis. Gut. 2001;48:251–259. - PMC - PubMed
    1. Yamamoto J, Kosuge T, Takyama T, et al. Recurrence of hepatocellular carcinoma after surgery. Br J Surg. 1996;83:1219–1222. - PubMed
    1. Poon R T-P, Fan S-T, Lo C-M, et al. Intrahepatic recurrence after curative resection of hepatocellular carcinoma. Long-term results of treatment and prognostic factors. Ann Surg. 1999;229:216–222. - PMC - PubMed
    1. Wall JW, Marotta PJ. Surgery and transplantation for hepatocellular carcinoma. Liver Transpl. 2000;6:S16–S22. - PubMed

Publication types

MeSH terms