Purpose
The optimal therapy for HCC seems to be transplantation. For all those patients not eligible for transplantation (or waiting for it) the treatment of choice has been restricted in the last years to resection (RES) or radiofrequency ablation (RFA). RFA is supposed to lose part of its efficacy for HCC ranging over 3 cm. Aim of this study is to compare RFA to RES in a restricted cohort of patients with a single naive HCC ranging from 3 to 5 cm and with not end stage liver disease.
Purpose
The optimal therapy for HCC seems to be transplantation. For all those patients not eligible for transplantation (or waiting for it) the treatment of choice has been restricted in the last years to resection (RES) or radiofrequency ablation (RFA). RFA is supposed to lose part of its efficacy for HCC ranging over 3 cm. Aim of this study is to compare RFA to RES in a restricted cohort of patients with a single naive HCC ranging from 3 to 5 cm and with not end stage liver disease.
Material and methods
102 naive patients were enrolled. Those patients whose HCC position required too parenchimal lost at RES (central or close to main vascular structures) were treated with RFA (68), all others underwent RES (34). The two groups were similar for HCC size (mean RES:RFA = 42:36 mm) and liver disease status. RES and RFA were performed by the same equipe equally skilled in both techniques. The outcome was considered in terms of overall survival (O.S.) and disease free survival (DFS).
Material and methods
102 naive patients were enrolled. Those patients whose HCC position required too parenchimal lost at RES (central or close to main vascular structures) were treated with RFA (68), all others underwent RES (34). The two groups were similar for HCC size (mean RES:RFA = 42:36 mm) and liver disease status. RES and RFA were performed by the same equipe equally skilled in both techniques. The outcome was considered in terms of overall survival (O.S.) and disease free survival (DFS).
Results
O.S. : RES vs. RFA at 1, 2, 3, 4, 5 years from treatment was respectively 83% vs. 90%; 58% vs. 70%; 50% vs. 46%; 43% vs. 23%; 30% vs. 8.5%. DFS: RES vs. RFA at 1, 2, 3, 4, 5 years was respectively 61% vs. 51%; 25% vs. 35%; 17% vs. 19%, 17% vs. 19%, 10% vs. 0%.
Results
O.S. : RES vs. RFA at 1, 2, 3, 4, 5 years from treatment was respectively 83% vs. 90%; 58% vs. 70%; 50% vs. 46%; 43% vs. 23%; 30% vs. 8.5%. DFS: RES vs. RFA at 1, 2, 3, 4, 5 years was respectively 61% vs. 51%; 25% vs. 35%; 17% vs. 19%, 17% vs. 19%, 10% vs. 0%.
Conclusion
Patients undergoing liver RES pay a higher risk of perioperative death compared to those undergoing RFA but have a higher chance of long O.S. and DFS.