Liver resection versus radiofrequency ablation for hepatitis B virus-related small hepatocellular carcinoma
Received 21 September 2017
Accepted for publication 17 November 2017
Published 12 January 2018 Volume 2018:5 Pages 1—7
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 3
Editor who approved publication: Professor Ahmed O Kaseb
Bin Liang,1,2 Siyang Yao,2 Jiapeng Zhou,3 Zongkui Li,1,2 Tianqi Liu2
1Department of Graduate School, The Guangxi Medical University, 2Department of Hepatobiliary Surgery, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, 3Department of Hepatobiliary Surgery, The First People’s Hospital of Qinzhou, Qinzhou, People’s Republic of China
Background: To compare the outcomes of liver resection (LR) with radiofrequency ablation (RFA) for patients with hepatitis B virus (HBV)-related small hepatocellular carcinoma (HCC).
Methods: A total of 122 HBV-related small HCC patients who underwent LR (n=64) or RFA (n=58) were involved in this retrospective study. Their basic clinical data, postoperative complications, survival outcomes, and prognostic factors were compared and analyzed.
Results: Patients in the LR group had more serious complications (11 versus 0) and longer postoperative hospital stays (11.3 versus 6.0 days) than those in the RFA group (all P<0.05). LR was associated with better recurrence-free survival (RFS) rates at 1, 3, and 5 years compared with RFA (90.4%, 65.9%, and 49.5% versus 79.3%, 50.3%, and 35.6%, P=0.037), but there was no significant difference in overall survival (OS) (95.2%, 78.1%, 58.6% versus 93.1%, 71.3%, 52.9%, P=0.309). Multivariate Cox analysis showed that the hepatic cirrhosis (hazard ratio [HR]: 2.13), tumor number (HR: 3.73), tumor diameter (HR: 1.92), and postoperative anti-HBV therapy (HR: 0.53) had predictive values for RFS, and the latter three (HR: 4.34, 2.30, and 0.44) were independent predictors of OS (all P<0.05).
Conclusion: LR might be considered the preferred method for patients with HBV-related small HCC, while RFA could apply to selective cases. Anti-HBV therapy after treatment was recommended.
Keywords: liver resection, hepatitis B virus, hepatocellular carcinoma, radiofrequency ablation, survival
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