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. 2021 Jun 14;19(1):175.
doi: 10.1186/s12957-021-02277-4.

Radiofrequency ablation versus repeat hepatectomy in the treatment of recurrent hepatocellular carcinoma in subcapsular location: a retrospective cohort study

Fuqun Wei #  1 , Qizhen Huang #  2 , Yang Zhou  1 , Liuping Luo  1 , Yongyi Zeng  3
Affiliations

Radiofrequency ablation versus repeat hepatectomy in the treatment of recurrent hepatocellular carcinoma in subcapsular location: a retrospective cohort study

Fuqun Wei et al. World J Surg Oncol. .

Abstract

Background: Repeat hepatectomy and radiofrequency ablation (RFA) are widely used to treat early recurrent hepatocellular carcinoma (RHCC) located in the subcapsular region, but the optimal treatment strategy remains to be controversial.

Methods: A total of 126 RHCC patients in the subcapsular location after initial radical hepatectomy were included in this study between Dec 2014 and Jan 2018. These patients were divided into the RFA group (46 cases) and the repeat hepatectomy group (80 cases). The primary endpoints include repeat recurrence-free survival (rRFS) and overall survival (OS), and the secondary endpoint was complications. The propensity-score matching (PSM) was conducted to minimize the bias. Complications were evaluated using the Clavien-Dindo classification, and severe complications were defined as classification of complications of ≥grade 3.

Results: There were no significant differences in the incidence of severe complications were observed between RFA group and repeat hepatectomy group in rRFS and OS both before (1-, 2-, and 3-year rRFS rates were 65.2%, 47.5%, and 33.3% vs 72.5%, 51.2%, and 39.2%, respectively, P = 0.48; 1-, 2-, and 3-year OS rates were 93.5%, 80.2%, and 67.9% vs 93.7%, 75.8%, and 64.2%, respectively, P = 0.92) and after PSM (1-, 2-, and 3-year rRFS rates were 68.6%, 51.0%, and 34.0% vs 71.4%, 42.9%, and 32.3%, respectively, P = 0.78; 1-, 2-, and 3-year OS rates were 94.3%, 82.9%, and 71.4% vs 88.6%, 73.8%, and 59.0%, respectively, P = 0.36). Moreover, no significant differences in the incidence of severe complications were observed between the RFA group and repeat hepatectomy group.

Conclusion: Both repeat hepatectomy and RFA are shown to be effective and safe for the treatment of RHCC located in the subcapsular region.

Keywords: Propensity-score matching; Radiofrequency ablation; Recurrent hepatocellular carcinoma; Repeat hepatectomy; Subcapsular location.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The flow chart of enrollment
Fig. 2
Fig. 2
Cumulative LTP rate and Kaplan-Meier OS rate curves generated before and after propensity-score matching in the RFA group. A Before PSM and B after PSM
Fig. 3
Fig. 3
Survival curves of all patients with recurrent hepatocellular carcinoma who underwent radiofrequency ablation and repeat hepatectomy groups. A Cumulative repeat disease-free survival (rRFS) curves and B cumulative overall survival (OS) curves before propensity-score matching. C Cumulative rRFS curves and D cumulative OS curves after propensity-score matching
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