IMPORTANCE Repeat hepatectomy and percutaneous radiofrequency ablation (PRFA) are most commonly used to treat early-stage recurrent hepatocellular carcinoma (RHCC) after initial resection, but previous studies comparing the effectiveness of the 2 treatments have reported conflicting results.OBJECTIVE To compare the long-term survival outcomes after repeat hepatectomy with those after PRFA among patients with early-stage RHCC. DESIGN, SETTING, AND PARTICIPANTSThis open-label randomized clinical trial was conducted at the Eastern Hepatobiliary Surgery Hospital and the National Center for Liver Cancer of China. A total of 240 patients with RHCC (with a solitary nodule diameter of Յ5 cm; 3 or fewer nodules, each Յ3 cm in diameter; and no macroscopic vascular invasion or distant metastasis) were randomized 1:1 to receive repeat hepatectomy or PRFA between

Early and late recurrences of solitary HCC after curative resection are associated with different predictive factors. The time to recurrence and further curative treatment after recurrence were the best predictors of survival post recurrence.

SUMMARYFully coupled, porous solid-fluid formulation, implementation and related modeling and simulation issues are presented in this work. To this end, coupled dynamic field equations with u − p −U formulation are used to simulate pore fluid and soil skeleton (elastic-plastic porous solid) responses. Present formulation allows, among other features, for water accelerations to be taken into account. This proves to be useful in modeling dynamic interaction of media of different stiffnesses (as in soil-foundation-structure interaction). Fluid compressibility is also explicitly taken into account, thus allowing excursions into modeling of limited cases of non-saturated porous media. In addition to these features, present formulation and implementation models in a realistic way the physical damping, which dissipates energy. In particular, the velocity proportional damping is appropriately modeled and simulated by taking into account the interaction of pore fluid and solid skeleton. Similarly, the displacement proportional damping is physically modeled through elastic-plastic processes in soil skeleton. An advanced material model for sand is used in present work and is discussed at some length. Also explored in this paper are the verification and validation issues related to fully coupled modeling and simulations of porous media.Illustrative examples describing the dynamical behavior of porous media (saturated soils) are presented. The verified and validated methods and material models are used to predict the behavior of level and sloping grounds subjected to seismic shaking.