Surgical Resection plus Radiofrequency Ablation versus Radical Surgery for Hepatocellular Carcinoma: A Propensity Score Matching Analysis

Zhou, Cheng; Zhang, Xiangyu; Peng, Yuan‐Fei; Zhou, Kaiyu; Hu, Jie; Yu, Lei; Chen, Feiyu; Qiu, Shuang–Jian; Zhou, Jian; Fan, Jian‐Gao; Zhang, Lan; Wang, Zheng

doi:10.7150/jca.29501

Cited by 4 publications

(3 citation statements)

References 34 publications

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“…Compared with LH treatment, bleeding is considerably reduced, and the possibility of transfusion is low during and after surgery in RFA treatment [ 31 ]. In contrast to RFA treatment, LH treatment must deal with the liver section that demands greater skills and dexterity from surgeons and causes a higher risk of related complications, such as postoperative hemorrhage, bile leakage, ascites, pleural effusion, and lung infection [ 32 ]. Patients treated with RFA may also experience postoperative bleeding, pain, and pleural effusion, but the incidence of complications is reportedly lower than that of LH treatment [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation versus laparoscopic hepatectomy for treatment of hepatocellular carcinoma: a systematic review and meta-analysis

et al. 2020

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Background: Several randomized controlled trials (RCTs) compared the effects of laparoscopic hepatectomy (LH) and radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC), but the results have remained inconsistent. Hence, a meta-analysis and a systematic review of these treatment modalities are necessary to evaluate their efficacy and safety for HCC treatment. Methods: From the inception of this meta-analysis and review until August 31, 2019, we searched Medline, PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, and China Biomedical Literature Database for RCTs involving LH and RFA treatments of patients with HCC. The studies were screened and the data from these articles were extracted independently by two authors. Summary odd ratios (OR) or mean differences (MD) with 95% confidence intervals (CI) were calculated for each outcome with a fixed-or random-effect model. The outcomes for effectiveness evaluations included duration of surgery, estimated bleeding volume, incidence of blood transfusion during surgery, duration of hospital stay, and the outcome for safety included the incidence of cancer recurrence. Results: Seven RCTs with a total of 615 patients were identified, 312 and 303 of which underwent RFA and LH treatments, respectively. The duration of surgery (MD = −99.04; 95% CI: −131.26-−66.82), estimated bleeding volume (MD = −241.97; 95% CI: −386.93-−97.02), incidence of blood transfusion during surgery (OR = 0.08; 95% CI: 0.02-0.37), and duration of hospital stay (MD = −3.4; 95% CI: −5.22-−1.57) in RFA treatment were significantly lower than those of LH treatment. However, the incidence of cancer recurrence was significantly higher for RFA treatment compared with LH treatment (OR = 2.68; 95% CI: 1.72-4.18). Conclusions: LH treatment is preferred over RFA treatment with a better radical effect, but RFA treatment is more beneficial with smaller trauma, development of less complications, and shorter operating time when compared with HCC treatment.

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Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation versus laparoscopic hepatectomy for treatment of hepatocellular carcinoma: a systematic review and meta-analysis

et al. 2020

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“…LT is recommended for those who are not good candidates for surgical resection and within Milan criteria (solitary tumor ≤5 cm or up to three nodules ≤3 cm) ( 9 ), but the scarcity of liver donors limits LT and patients drop out due to tumor progression while being in the waiting line ( 10 ). In addition, LTD with methods such as radiofrequency ablation (RFA) has gained popularity due to its ease of use, safety, and minimal invasiveness ( 11 ). Surgical resection is superior to RFA in terms of recurrence-free survival and local recurrence rate.…”

Section: Introductionmentioning

confidence: 99%

Surgical therapy and survival in young patients with stage I–II hepatocellular carcinoma: a retrospective cohort study

Zhang¹,

Jiang²,

Huang³

et al. 2022

Transl Cancer Res TCR

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Background: Hepatocellular carcinoma (HCC) is regarded as a high-mortality cancer, but the effectiveness of surgical strategies for young patients with early-stage HCC remains controversial. We aimed to analyze the survival in young patients with stage I-II HCC who underwent different kinds of surgical treatments. Methods: Overall survival (OS) and cancer-specific survival (CSS) were compared among patients aged 18-45 years with stage I-II HCC from the Surveillance, Epidemiology, and End Results (SEER) database (2004-2013) who underwent local tumor destruction (LTD), wedge or segmental resection (WSR), lobectomy resection (LR), liver transplantation (LT), or non-surgery. Univariate and multivariate analyses and Kaplan-Meier method were used to examine the OS and CSS of the patients. A stratification analysis of CSS was also conducted among the subgroups.Results: Data from 664 patients were extracted. The median survival time was 46 months. In the multivariate analysis of OS, compared with non-surgery, LTD [hazard ratio (HR), 0.37; 95% confidence interval (CI): 0.25-0.54; P<0.0001], LR (HR, 0.29; 95% CI: 0.19-0.45; P<0.0001), and WSR (HR, 0.26; 95% CI: 0.17-0.39; P<0.0001) had better outcomes, and LT had the best survival benefit (HR, 0.24; 95% CI: 0.16-0.36; P<0.0001), which was similar to CSS. In the stratification analysis, compared with the nonsurgery group, among patients with chemotherapy, LT reduced the risk of CSS by 64% (HR, 0.36; 95% CI: 0.19-0.66; P interaction=0.0004).Conclusions: Surgery offers a survival benefit compared with non-surgery for young patients with stage I-II HCC. LT is associated with better survival than WSR, LR, and LTD.

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“…Hepatocellular carcinoma (HCC) is a common digestive system tumor and the sixth most common type of cancer worldwide ( 2 ). Treatment includes radical surgery ( 3 ), molecular targeted therapies ( 4 ) and neoadjuvant therapy ( 5 ). Although progress has been made in the treatment of HCC, the prognosis of HCC patients is still poor and the 5-year survival rate is only about 18% ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Photodynamic and Photothermal Therapy of Hepatocellular Carcinoma

2021

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Hepatocellular carcinoma (HCC) is the most common primary liver tumor. It is ranked the sixth most common neoplasm and the third most common cause of cancer mortality. At present, the most common treatment for HCC is surgery, but the 5-year recurrence rates are still high. Patients with early stage HCC with few nodules can be treated with resection or radiofrequency ablation (RFA); while for multinodular HCC, transarterial chemoembolization (TACE) has been the first-line treatment. In recent years, based on medical engineering cooperation, nanotechnology has been increasingly applied to the treatment of cancer. Photodynamic therapy and photothermal therapy are effective for cancer. This paper summarizes the latest progress of photodynamic therapy and photothermal therapy for HCC, with the aim of providing new ideas for the treatment of HCC.

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Surgical Resection plus Radiofrequency Ablation versus Radical Surgery for Hepatocellular Carcinoma: A Propensity Score Matching Analysis

Cited by 4 publications

References 34 publications

Radiofrequency ablation versus laparoscopic hepatectomy for treatment of hepatocellular carcinoma: a systematic review and meta-analysis

Radiofrequency ablation versus laparoscopic hepatectomy for treatment of hepatocellular carcinoma: a systematic review and meta-analysis

Surgical therapy and survival in young patients with stage I–II hepatocellular carcinoma: a retrospective cohort study

Photodynamic and Photothermal Therapy of Hepatocellular Carcinoma

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