Radiofrequency ablation versus surgical resection for single nodule hepatocellular carcinoma: Long‐term outcomes

Abstract

Background Radiofrequency ablation (RFA) has been increasingly utilized for treatment of hepatocellular carcinoma (HCC). Long‐term results of RFA, especially in comparison to surgical resection, have not been well described. Methods Eighty‐seven patients with single nodule HCC underwent surgical resection (N=47) or RFA (N=40) during a 9‐year period. RFA was performed for 36 unresectable disease and 4 surgical refusals. Each group was further divided based on tumor size for analysis; Group 1: resection, 5cm (N=18), Group 2: RFA, 5cm (N=26), Group 3: resection, >5cm (N=29) and Group 4: RFA, >5cm (N=14). Follow‐up ranged from 2 to 72 months (median 16 months). Patients' characteristics, local recurrences and overall and disease‐free survivals were compared. Results Patients who underwent RFA were older (69 versus 60, p=0.0006), had more advanced Child‐Pugh class and TNM stage (p=0.0002 and p=0.016, respectively), and had smaller tumors (4.6 versus 7.4 cm, p=0.0032). Local recurrence rates were 2% for resection and 10% for RFA (p=0.12). These local and other recurrences were subsequently treated with multimodal therapies as indicated. The median overall and disease‐free survivals were equivalent both between Groups 1 and 2 (49 versus 51 months, p=0.44, 36 versus 22 months, p=0.84), and Groups 3 and 4 (47 versus >63 months, p=0.94, 28 versus 20 months, p=0.67). Discussion Although the groups were not truly comparable, this retrospective study suggests that RFA may offer similar long‐term results to surgical resection for single nodule HCC when combined with multimodal treatments.