Abstract
Background & Aims: The treatment of choice for early or moderately advanced hepatocellular carcinoma (HCC) with good liver function remains controversial. We evaluated the therapeutic impacts of surgical resection (SR), percutaneous ethanol injection (PEI), and radiofrequency ablation (RFA) on long-term outcomes in patients with HCC. Methods: A database constructed on the basis of a Japanese nationwide survey of 28,510 patients with HCC treated by SR, PEI, or RFA between 2000 and 2005 was used to identify 12,968 patients who had no more than 3 tumors (≤3 cm) and liver damage of class A or B. The patients were divided into SR (n = 5361), RFA (n = 5548), and PEI groups (n = 2059). Overall survival and time to recurrence were compared among them. Results: Median follow-up was 2.16 years. Overall survival at 3 and 5 years was respectively 85.3%/71.1% in the SR group, 81.0%/61.1% in the RFA, and 78.9%/56.3% in the PEI. Time to recurrence at 3 and 5 years was 43.3%/63.8%, 57.2%/71.7%, and 64.3%/76.9%, respectively. On multivariate analysis, the hazard ratio for death was significantly lower in the SR group than in the RFA (SR vs. RFA:0.84, 95% confidence interval, 0.74-0.95; p = 0.006) and PEI groups (SR vs. PEI:0.75, 0.64-0.86; p = 0.0001). The hazard ratios for recurrence were also lower in the SR group than in the RFA (SR vs. RFA:0.74, 0.68-0.79; p = 0.0001) and PEI groups (SR vs. PEI:0.59, 0.54-0.65; p = 0.0001). Conclusions: Our findings suggest that surgical resection results in longer overall survival and shorter time to recurrence than either RFA or PEI in patients with HCC.
| Original language | English |
|---|---|
| Pages (from-to) | 724-729 |
| Number of pages | 6 |
| Journal | Journal of Hepatology |
| Volume | 58 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2013 Apr |
Fingerprint
Keywords
- Hepatectomy
- Percutaneous ethanol injection
- Radiofrequency ablation
- Surgical resection
ASJC Scopus subject areas
- Hepatology
Cite this
Comparison of resection and ablation for hepatocellular carcinoma : A cohort study based on a Japanese nationwide survey. / Hasegawa, Kiyoshi; Kokudo, Norihiro; Makuuchi, Masatoshi; Izumi, Namiki; Ichida, Takafumi; Kudo, Masatoshi; Ku, Yonson; Sakamoto, Michiie; Nakashima, Osamu; Matsui, Osamu; Matsuyama, Yutaka.
In: Journal of Hepatology, Vol. 58, No. 4, 04.2013, p. 724-729.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison of resection and ablation for hepatocellular carcinoma
T2 - A cohort study based on a Japanese nationwide survey
AU - Hasegawa, Kiyoshi
AU - Kokudo, Norihiro
AU - Makuuchi, Masatoshi
AU - Izumi, Namiki
AU - Ichida, Takafumi
AU - Kudo, Masatoshi
AU - Ku, Yonson
AU - Sakamoto, Michiie
AU - Nakashima, Osamu
AU - Matsui, Osamu
AU - Matsuyama, Yutaka
PY - 2013/4
Y1 - 2013/4
N2 - Background & Aims: The treatment of choice for early or moderately advanced hepatocellular carcinoma (HCC) with good liver function remains controversial. We evaluated the therapeutic impacts of surgical resection (SR), percutaneous ethanol injection (PEI), and radiofrequency ablation (RFA) on long-term outcomes in patients with HCC. Methods: A database constructed on the basis of a Japanese nationwide survey of 28,510 patients with HCC treated by SR, PEI, or RFA between 2000 and 2005 was used to identify 12,968 patients who had no more than 3 tumors (≤3 cm) and liver damage of class A or B. The patients were divided into SR (n = 5361), RFA (n = 5548), and PEI groups (n = 2059). Overall survival and time to recurrence were compared among them. Results: Median follow-up was 2.16 years. Overall survival at 3 and 5 years was respectively 85.3%/71.1% in the SR group, 81.0%/61.1% in the RFA, and 78.9%/56.3% in the PEI. Time to recurrence at 3 and 5 years was 43.3%/63.8%, 57.2%/71.7%, and 64.3%/76.9%, respectively. On multivariate analysis, the hazard ratio for death was significantly lower in the SR group than in the RFA (SR vs. RFA:0.84, 95% confidence interval, 0.74-0.95; p = 0.006) and PEI groups (SR vs. PEI:0.75, 0.64-0.86; p = 0.0001). The hazard ratios for recurrence were also lower in the SR group than in the RFA (SR vs. RFA:0.74, 0.68-0.79; p = 0.0001) and PEI groups (SR vs. PEI:0.59, 0.54-0.65; p = 0.0001). Conclusions: Our findings suggest that surgical resection results in longer overall survival and shorter time to recurrence than either RFA or PEI in patients with HCC.
AB - Background & Aims: The treatment of choice for early or moderately advanced hepatocellular carcinoma (HCC) with good liver function remains controversial. We evaluated the therapeutic impacts of surgical resection (SR), percutaneous ethanol injection (PEI), and radiofrequency ablation (RFA) on long-term outcomes in patients with HCC. Methods: A database constructed on the basis of a Japanese nationwide survey of 28,510 patients with HCC treated by SR, PEI, or RFA between 2000 and 2005 was used to identify 12,968 patients who had no more than 3 tumors (≤3 cm) and liver damage of class A or B. The patients were divided into SR (n = 5361), RFA (n = 5548), and PEI groups (n = 2059). Overall survival and time to recurrence were compared among them. Results: Median follow-up was 2.16 years. Overall survival at 3 and 5 years was respectively 85.3%/71.1% in the SR group, 81.0%/61.1% in the RFA, and 78.9%/56.3% in the PEI. Time to recurrence at 3 and 5 years was 43.3%/63.8%, 57.2%/71.7%, and 64.3%/76.9%, respectively. On multivariate analysis, the hazard ratio for death was significantly lower in the SR group than in the RFA (SR vs. RFA:0.84, 95% confidence interval, 0.74-0.95; p = 0.006) and PEI groups (SR vs. PEI:0.75, 0.64-0.86; p = 0.0001). The hazard ratios for recurrence were also lower in the SR group than in the RFA (SR vs. RFA:0.74, 0.68-0.79; p = 0.0001) and PEI groups (SR vs. PEI:0.59, 0.54-0.65; p = 0.0001). Conclusions: Our findings suggest that surgical resection results in longer overall survival and shorter time to recurrence than either RFA or PEI in patients with HCC.
KW - Hepatectomy
KW - Percutaneous ethanol injection
KW - Radiofrequency ablation
KW - Surgical resection
UR - http://www.scopus.com/inward/record.url?scp=84880948632&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84880948632&partnerID=8YFLogxK
U2 - 10.1016/j.jhep.2012.11.009
DO - 10.1016/j.jhep.2012.11.009
M3 - Article
C2 - 23178708
AN - SCOPUS:84880948632
VL - 58
SP - 724
EP - 729
JO - Journal of Hepatology
JF - Journal of Hepatology
SN - 0168-8278
IS - 4
ER -