Patients with hepatocellular carcinoma of smaller size experienced similar survival and safety outcomes from hepatic resection and radiofrequency ablation in a study presented at the International Liver Cancer Association Annual Conference in Washington, DC.
Researchers evaluated 659 patients who developed hepatocellular carcinoma (HCC) between 1999 and 2007. Patients included 289 who received percutaneous, ultrasound-guided radiofrequency ablation (RFA) while under general anesthesia, and 370 who underwent hepatic resection as initial curative therapy. All nodules were 5 cm in size or smaller.
“Whether RFA is a feasible alternative treatment for small HCC remains controversial,” the researchers wrote. “Thus, instead of a randomized controlled trial, we conducted a propensity analysis to compare the outcomes of RFA versus surgery.”
At 5 years after treatment, survival rates were 65% of RFA recipients and 68% of surgery recipients, while recurrence-free survival rates were 27% and 26%, respectively. The two methods did not differ significantly on Cox proportional hazards analysis, or on propensity analysis incorporating 146 propensity-score-matched pairs from each group. Investigators said patients with poor liver function were more likely to undergo RFA, while patients with highly malignant tumors were more likely undergo resection.
Bleeding into the abdominal cavity occurred in 0.3% of patients who received RFA. Death due to surgery-related complications occurred in 0.5% of resected patients.
“There was no difference in either overall or recurrence-free survival between patients undergoing RFA and those treated surgically,” the researchers concluded. “If appropriate patient selection criteria are applied, RFA under general anesthesia is a safe and effective treatment for small HCC.”
Disclosure: The researchers report no relevant financial disclosures.
For more information:
Saito A. P-125: Radiofrequency Ablation Under General Anesthesia Versus Hepatic Resection for Hepatocellular Carcinoma. Presented at: The International Liver Cancer Association Annual Conference 2013; Sept. 13-15, Washington, DC.