Radiofrequency ablation is an inferior option to liver resection for solitary hepatocellular carcinoma≤5 cm without cirrhosis:A population-based study with stratification by tumor size  

作　　者：Song-Chen Dong Dou-Sheng Bai Fu-An Wang Sheng-Jie Jin Chi Zhang Bao-Huan Zhou Guo-Qing Jiang 

机构地区：[1]Department of Hepatobiliary Surgery,Clinical Medical College,Yangzhou University,Yangzhou 225001,China [2]Department of Hepatobiliary Surgery,The First Clinical College,Dalian Medical University,Dalian 116000,China [3]Department of Interventional Radiology,Clinical Medical College,Yangzhou University,Yangzhou 225001,China

出　　处：《Hepatobiliary & Pancreatic Diseases International》2023年第6期605-614,共10页国际肝胆胰疾病杂志（英文版）

基　　金：the National Natural Science Foundation of China(82173353);Top talent scientific research project of“six one projects”(LGY2018028).

摘　　要：Background:About 10%-20%of all individuals who develop hepatocellular carcinoma(HCC)do not have cirrhosis.Comparisons are rarely reported regarding the effectiveness of radiofrequency ablation(RFA)and liver resection(LR)in survival of HCC without cirrhosis and stratification by tumor size≤5 cm.Methods:We used the Surveillance,Epidemiology,and End Results(SEER)database and identified 1505 patients with a solitary HCC tumor≤5 cm who underwent RFA or LR during 2004-2015.Patients were classified into non-cirrhosis and cirrhosis groups and each group was categorized into three subgroups,according to tumor size(≤30 mm,31-40 mm,41-50 mm).Results:In patients without cirrhosis,LR showed better 5-year HCC cancer-specific survival than RFA in all tumor size subgroups(≤30 mm:82.51%vs.56.42%;31-40 mm:71.31%vs.46.83%;41-50 mm:74.7%vs.37.5%;all P<0.05).Compared with RFA,LR was an independent protective factor for HCC cancer-specific survival in multivariate Cox analysis[≤30 mm:hazard ratio(HR)=0.533,95%confidence interval(CI):0.313-0.908;31-40 mm:HR=0.439,95%CI:0.201-0.957;41-50 mm:HR=0.382;95%CI:0.159-0.916;all P<0.05].In patients with cirrhosis,for both tumor size≤30 mm and 31-40 mm groups,there were no significant survival differences between RFA and LR in multivariate analysis(all P>0.05).However,in those with tumor size 41-50 mm,LR showed significantly better 5-year HCC cancer-specific survival than RFA in both univariate(54.72%vs.23.06%;P<0.001)and multivariate analyses(HR=0.297;95%CI:0.136-0.648;P=0.002).Conclusions:RFA is an inferior treatment option to LR for patients without cirrhosis who have a solitary HCC tumor≤5 cm.

关 键 词：Cirrhosis Liver resection Radiofrequency ablation Hepatocellular carcinoma Tumor size 

分 类 号：R735.7[医药卫生—肿瘤]