Clinical outcomes of surgical resection versus radiofrequency ablation in very-early‐stage hepatocellular carcinoma: a propensity score matching analysis

Abstract Background The detection rate of Barcelona Clinic Liver Cancer (BCLC) very-early-stage hepatocellular carcinoma (HCC) is increasing because of advances in surveillance and improved imaging technologies for high-risk populations. Surgical resection (SR) and radiofrequency ablation (RFA) are...

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Autores principales:	Yuan-Chen Li, Ping-Hung Chen, Jen-Hao Yeh, Pojen Hsiao, Gin-Ho Lo, TaoQian Tan, Pin-Nan Cheng, Hung-Yu Lin, Yaw-Sen Chen, Kun-Chou Hsieh, Pei-Min Hsieh, Chih-Wen Lin
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Surgical procedures Radiofrequency ablation Very-early-stage hepatocellular carcinoma Overall survival Disease-free survival Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/850c695ce76e4112bcd27dda36583dd1
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spelling	oai:doaj.org-article:850c695ce76e4112bcd27dda36583dd12021-11-14T12:16:52ZClinical outcomes of surgical resection versus radiofrequency ablation in very-early‐stage hepatocellular carcinoma: a propensity score matching analysis10.1186/s12876-021-01995-z1471-230Xhttps://doaj.org/article/850c695ce76e4112bcd27dda36583dd12021-11-01T00:00:00Zhttps://doi.org/10.1186/s12876-021-01995-zhttps://doaj.org/toc/1471-230XAbstract Background The detection rate of Barcelona Clinic Liver Cancer (BCLC) very-early-stage hepatocellular carcinoma (HCC) is increasing because of advances in surveillance and improved imaging technologies for high-risk populations. Surgical resection (SR) and radiofrequency ablation (RFA) are both first‐line treatments for very-early-stage HCC, but the differences in clinical outcomes between patients treated with SR and RFA remain unclear. This study investigated the prognosis of SR and RFA for very-early‐stage HCC patients with long‐term follow‐up. Methods This study was retrospectively collected data on the clinicopathological characteristics, overall survival (OS), and disease-free survival (DFS) of 188 very-early-stage HCC patients (≤ 2 cm single HCC). OS and DFS were analyzed using the Kaplan–Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed. Results Of the 188 HCC patients, 103 received SR and 85 received RFA. The median follow‐up time was 56 months. The SR group had significantly higher OS than the RFA group (10-year cumulative OS: 55.2% and 31.3% in the SR and RFA groups, respectively). No statistically significant difference was observed in DFS between the SR and RFA groups (10-year cumulative DFS: 45.9% and 32.6% in the SR and RFA groups, respectively). After PSM, the OS in the SR group remained significantly higher than that in the RFA group (10-year cumulative OS: 54.7% and 42.2% in the SR and RFA groups, respectively). No significant difference was observed in DFS between the SR and RFA groups (10-year cumulative DFS: 43.0% and 35.4% in the SR and RFA groups, respectively). Furthermore, in the multivariate Cox regression analysis, treatment type (hazard ratio (HR): 0.54, 95% confidence interval (CI): 0.31–0.95; P = 0.032) and total bilirubin (HR: 1.92; 95% CI: 1.09–3.41; P = 0.025) were highly associated with OS. In addition, age (HR: 2.14, 95% CI: 1.36–3.36; P = 0.001) and cirrhosis (HR: 1.79; 95% CI: 1.11–2.89; P = 0.018) were strongly associated with DFS. Conclusion For patients with very-early-stage HCC, SR was associated with significantly higher OS rates than RFA. However, no significant difference was observed in DFS between the SR and RFA groups.Yuan-Chen LiPing-Hung ChenJen-Hao YehPojen HsiaoGin-Ho LoTaoQian TanPin-Nan ChengHung-Yu LinYaw-Sen ChenKun-Chou HsiehPei-Min HsiehChih-Wen LinBMCarticleSurgical proceduresRadiofrequency ablationVery-early-stage hepatocellular carcinomaOverall survivalDisease-free survivalDiseases of the digestive system. GastroenterologyRC799-869ENBMC Gastroenterology, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Surgical procedures Radiofrequency ablation Very-early-stage hepatocellular carcinoma Overall survival Disease-free survival Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Surgical procedures Radiofrequency ablation Very-early-stage hepatocellular carcinoma Overall survival Disease-free survival Diseases of the digestive system. Gastroenterology RC799-869 Yuan-Chen Li Ping-Hung Chen Jen-Hao Yeh Pojen Hsiao Gin-Ho Lo TaoQian Tan Pin-Nan Cheng Hung-Yu Lin Yaw-Sen Chen Kun-Chou Hsieh Pei-Min Hsieh Chih-Wen Lin Clinical outcomes of surgical resection versus radiofrequency ablation in very-early‐stage hepatocellular carcinoma: a propensity score matching analysis
description	Abstract Background The detection rate of Barcelona Clinic Liver Cancer (BCLC) very-early-stage hepatocellular carcinoma (HCC) is increasing because of advances in surveillance and improved imaging technologies for high-risk populations. Surgical resection (SR) and radiofrequency ablation (RFA) are both first‐line treatments for very-early-stage HCC, but the differences in clinical outcomes between patients treated with SR and RFA remain unclear. This study investigated the prognosis of SR and RFA for very-early‐stage HCC patients with long‐term follow‐up. Methods This study was retrospectively collected data on the clinicopathological characteristics, overall survival (OS), and disease-free survival (DFS) of 188 very-early-stage HCC patients (≤ 2 cm single HCC). OS and DFS were analyzed using the Kaplan–Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed. Results Of the 188 HCC patients, 103 received SR and 85 received RFA. The median follow‐up time was 56 months. The SR group had significantly higher OS than the RFA group (10-year cumulative OS: 55.2% and 31.3% in the SR and RFA groups, respectively). No statistically significant difference was observed in DFS between the SR and RFA groups (10-year cumulative DFS: 45.9% and 32.6% in the SR and RFA groups, respectively). After PSM, the OS in the SR group remained significantly higher than that in the RFA group (10-year cumulative OS: 54.7% and 42.2% in the SR and RFA groups, respectively). No significant difference was observed in DFS between the SR and RFA groups (10-year cumulative DFS: 43.0% and 35.4% in the SR and RFA groups, respectively). Furthermore, in the multivariate Cox regression analysis, treatment type (hazard ratio (HR): 0.54, 95% confidence interval (CI): 0.31–0.95; P = 0.032) and total bilirubin (HR: 1.92; 95% CI: 1.09–3.41; P = 0.025) were highly associated with OS. In addition, age (HR: 2.14, 95% CI: 1.36–3.36; P = 0.001) and cirrhosis (HR: 1.79; 95% CI: 1.11–2.89; P = 0.018) were strongly associated with DFS. Conclusion For patients with very-early-stage HCC, SR was associated with significantly higher OS rates than RFA. However, no significant difference was observed in DFS between the SR and RFA groups.
format	article
author	Yuan-Chen Li Ping-Hung Chen Jen-Hao Yeh Pojen Hsiao Gin-Ho Lo TaoQian Tan Pin-Nan Cheng Hung-Yu Lin Yaw-Sen Chen Kun-Chou Hsieh Pei-Min Hsieh Chih-Wen Lin
author_facet	Yuan-Chen Li Ping-Hung Chen Jen-Hao Yeh Pojen Hsiao Gin-Ho Lo TaoQian Tan Pin-Nan Cheng Hung-Yu Lin Yaw-Sen Chen Kun-Chou Hsieh Pei-Min Hsieh Chih-Wen Lin
author_sort	Yuan-Chen Li
title	Clinical outcomes of surgical resection versus radiofrequency ablation in very-early‐stage hepatocellular carcinoma: a propensity score matching analysis
title_short	Clinical outcomes of surgical resection versus radiofrequency ablation in very-early‐stage hepatocellular carcinoma: a propensity score matching analysis
title_full	Clinical outcomes of surgical resection versus radiofrequency ablation in very-early‐stage hepatocellular carcinoma: a propensity score matching analysis
title_fullStr	Clinical outcomes of surgical resection versus radiofrequency ablation in very-early‐stage hepatocellular carcinoma: a propensity score matching analysis
title_full_unstemmed	Clinical outcomes of surgical resection versus radiofrequency ablation in very-early‐stage hepatocellular carcinoma: a propensity score matching analysis
title_sort	clinical outcomes of surgical resection versus radiofrequency ablation in very-early‐stage hepatocellular carcinoma: a propensity score matching analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/850c695ce76e4112bcd27dda36583dd1
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Clinical outcomes of surgical resection versus radiofrequency ablation in very-early‐stage hepatocellular carcinoma: a propensity score matching analysis

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