Conventional Chemoembolization Plus Radiofrequency Ablation versus Surgical Resection for Single,Medium-Sized Hepatocellular Carcinoma: Propensity-Score Matching Analysis |
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Authors: | Hyo-jae Lee Jin Woong Kim Young Hoe Hur Sung Bum Cho Byung Chan Lee Byung Kook Lee Eu Chang Hwang Yong Soo Cho Hyun Ju Seon |
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Institution: | 1. Department of Radiology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Republic of Korea;2. Department of Hepato-Pancreato-Biliary Surgery, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Republic of Korea;3. Department of Internal Medicine, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Republic of Korea;4. Department of Emergency Medicine, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Republic of Korea;5. Department of Urology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Republic of Korea;6. Department of Radiology, Chosun University Hospital and Chosun University College of Medicine, Gwangju, Republic of Korea |
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Abstract: | PurposeTo retrospectively compare long-term outcomes of conventional chemoembolization plus radiofrequency (RF) ablation vs those of surgical resection in patients with a single 3–5-cm hepatocellular carcinoma (HCC).Materials and MethodsFrom January 2008 to December 2017, 139 of 623 patients who underwent surgical resection and 60 of 186 patients who underwent chemoembolization/RF ablation in a single center were compared with respect to local tumor progression (LTP), intrahepatic distant recurrence (IDR), disease-free survival (DFS), overall survival (OS), major complications, and hospital stay before and after propensity-score matching.ResultsMean follow-up periods were similar in the chemoembolization/RF ablation and surgical resection groups (41.9 mo vs 48.4 mo). Three (5%) and 17 (28.3%) patients in the chemoembolization/RF ablation group and 12 (8.6%) and 57 (41.0%) patients in the surgical resection group showed LTP and IDR (P = .366 and P =.114, respectively). At 1, 3, and 5 years, respective DFS rates were 88.1%, 65.3%, and 49.0% for chemoembolization/RF ablation and 84.2%, 58.2%, and 46.5% for surgical resection (P = .294). Moreover, respective OS rates were 95.0%, 73.5%, and 54.0% for chemoembolization/RF ablation and 97.1%, 87.4%, and 75.0% for surgical resection (P = .055). After matching (n = 52), therapeutic outcomes remained similar (P = .370, P = .110, P = .230, and P = .760, respectively). Surgical resection was associated with higher complication rates (P = .015) and longer hospital stays (8.4 d ± 3.7 vs 16.9 d ± 7.0; P < .001).ConclusionsConventional chemoembolization combined with RF ablation may be feasible for single 3–5-cm HCCs, with comparable therapeutic outcomes vs surgical resection and shorter hospital stays. |
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Keywords: | BCLC Barcelona Clinic Liver Cancer CCI Charlson Comorbidity Index CI confidence interval DFS disease-free survival HCC hepatocellular carcinoma HR hazard ratio IDR intrahepatic distant recurrence LTP local tumor progression OS overall survival RF radiofrequency |
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