Surgical Resection Versus Radiofrequency Ablation in the Treatment of Small Unifocal Hepatocellular Carcinoma
Background Hepatocellular carcinoma (HCC) has a high worldwide prevalence and mortality. While surgical resection and transplantation offers curative potential, donor availability and patient liver status and comorbidities may disallow either. Interventional radiological techniques such as radiofreq...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2008-09, Vol.12 (9), p.1521-1526 |
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| creator | Abu-Hilal, M. Primrose, J. N. Casaril, A. McPhail, M. J. W. Pearce, N. W. Nicoli, N. |
| description | Background
Hepatocellular carcinoma (HCC) has a high worldwide prevalence and mortality. While surgical resection and transplantation offers curative potential, donor availability and patient liver status and comorbidities may disallow either. Interventional radiological techniques such as radiofrequency ablation (RFA) may offer acceptable overall and disease-free survival rates.
Materials and Methods
Sixty-eight cirrhotic patients matched for age, sex, tumor size, and Child–Pugh grade with small (1–5 cm) unifocal HCC were studied retrospectively to find determinants of overall and disease-free survival in those treated with surgical resection and RFA between 1991 and 2003.
Results
Multivariate analysis using Cox proportional regression modeling showed that overall survival was related to tumor recurrence (
p
= 0.010), tumor diameter (
p
= 0.002), and treatment modality (
p
= 0.014); overall
p
= 0.008. Recurrence was independently related to the use of RFA over surgery (
p
= 0.023) on multivariate analysis; overall
p
= 0.034.
Conclusion
Surgical resection offers longer disease-free survival and potentially longer overall survival than RFA in patients with small unifocal HCC. |
| doi_str_mv | 10.1007/s11605-008-0553-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_69438893</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2790393371</sourcerecordid><originalsourceid>FETCH-LOGICAL-p210t-4da27365f582299356fae9f15c8abf28c9d13e7db320753dfef0a395154f6f8f3</originalsourceid><addsrcrecordid>eNpdkU9r3DAUxEVp6KabfIBeiqCQmxM9yZKlY1iSbiEQyD9yE1r7aetgS1vJPuTbR9tNoeT0BubHMLwh5Buwc2CsucgAismKMV0xKUVVfyLHoJsiFFefi2YGKi7l84J8zfmFMWgY6C9kAVoaLrg8JuP9nLZ96wZ6hxnbqY-BPmHKc6Z3ruujT_hnxtC-0svN4P7afaDTb6QPCd00Ypho9PR-dMNAH0Pv4z5rjTs3xRaHYR5coiuX2j7E0Z2QI--GjKfvd0ker68eVuvq5vbnr9XlTbXjwKaq7hxvhJJeas6NEVJ5h8aDbLXbeK5b04HAptsIzhopOo-eOWEkyNorr71YkrND7i7FUj9Pduzzvo4LGOdslamF1kYU8McH8CXOKZRuFgC4UEpDU6jv79S8GbGzu9SPLr3af28sAD8AuVhhi-m_GGb3W9nDVrZsZfdb2Vq8Ac4ShTM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1112366817</pqid></control><display><type>article</type><title>Surgical Resection Versus Radiofrequency Ablation in the Treatment of Small Unifocal Hepatocellular Carcinoma</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Abu-Hilal, M. ; Primrose, J. N. ; Casaril, A. ; McPhail, M. J. W. ; Pearce, N. W. ; Nicoli, N.</creator><creatorcontrib>Abu-Hilal, M. ; Primrose, J. N. ; Casaril, A. ; McPhail, M. J. W. ; Pearce, N. W. ; Nicoli, N.</creatorcontrib><description>Background
Hepatocellular carcinoma (HCC) has a high worldwide prevalence and mortality. While surgical resection and transplantation offers curative potential, donor availability and patient liver status and comorbidities may disallow either. Interventional radiological techniques such as radiofrequency ablation (RFA) may offer acceptable overall and disease-free survival rates.
Materials and Methods
Sixty-eight cirrhotic patients matched for age, sex, tumor size, and Child–Pugh grade with small (1–5 cm) unifocal HCC were studied retrospectively to find determinants of overall and disease-free survival in those treated with surgical resection and RFA between 1991 and 2003.
Results
Multivariate analysis using Cox proportional regression modeling showed that overall survival was related to tumor recurrence (
p
= 0.010), tumor diameter (
p
= 0.002), and treatment modality (
p
= 0.014); overall
p
= 0.008. Recurrence was independently related to the use of RFA over surgery (
p
= 0.023) on multivariate analysis; overall
p
= 0.034.
Conclusion
Surgical resection offers longer disease-free survival and potentially longer overall survival than RFA in patients with small unifocal HCC.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-008-0553-4</identifier><identifier>PMID: 18592325</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Aged ; Cancer ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - surgery ; Catheter Ablation - methods ; Cohort Studies ; Disease-Free Survival ; Female ; Follow-Up Studies ; Gastroenterology ; Hepatectomy - methods ; Humans ; Immunohistochemistry ; Kaplan-Meier Estimate ; Liver cancer ; Liver cirrhosis ; Liver Neoplasms - mortality ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Multivariate Analysis ; Neoplasm Staging ; Original Article ; Postoperative Complications - mortality ; Probability ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; Statistics, Nonparametric ; Surgery ; Survival Analysis ; Treatment Outcome ; Tumors</subject><ispartof>Journal of gastrointestinal surgery, 2008-09, Vol.12 (9), p.1521-1526</ispartof><rights>The Society for Surgery of the Alimentary Tract 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-p210t-4da27365f582299356fae9f15c8abf28c9d13e7db320753dfef0a395154f6f8f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-008-0553-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-008-0553-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18592325$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abu-Hilal, M.</creatorcontrib><creatorcontrib>Primrose, J. N.</creatorcontrib><creatorcontrib>Casaril, A.</creatorcontrib><creatorcontrib>McPhail, M. J. W.</creatorcontrib><creatorcontrib>Pearce, N. W.</creatorcontrib><creatorcontrib>Nicoli, N.</creatorcontrib><title>Surgical Resection Versus Radiofrequency Ablation in the Treatment of Small Unifocal Hepatocellular Carcinoma</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description>Background
Hepatocellular carcinoma (HCC) has a high worldwide prevalence and mortality. While surgical resection and transplantation offers curative potential, donor availability and patient liver status and comorbidities may disallow either. Interventional radiological techniques such as radiofrequency ablation (RFA) may offer acceptable overall and disease-free survival rates.
Materials and Methods
Sixty-eight cirrhotic patients matched for age, sex, tumor size, and Child–Pugh grade with small (1–5 cm) unifocal HCC were studied retrospectively to find determinants of overall and disease-free survival in those treated with surgical resection and RFA between 1991 and 2003.
Results
Multivariate analysis using Cox proportional regression modeling showed that overall survival was related to tumor recurrence (
p
= 0.010), tumor diameter (
p
= 0.002), and treatment modality (
p
= 0.014); overall
p
= 0.008. Recurrence was independently related to the use of RFA over surgery (
p
= 0.023) on multivariate analysis; overall
p
= 0.034.
Conclusion
Surgical resection offers longer disease-free survival and potentially longer overall survival than RFA in patients with small unifocal HCC.</description><subject>Aged</subject><subject>Cancer</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Catheter Ablation - methods</subject><subject>Cohort Studies</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology</subject><subject>Hepatectomy - methods</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Kaplan-Meier Estimate</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Staging</subject><subject>Original Article</subject><subject>Postoperative Complications - mortality</subject><subject>Probability</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Statistics, Nonparametric</subject><subject>Surgery</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNpdkU9r3DAUxEVp6KabfIBeiqCQmxM9yZKlY1iSbiEQyD9yE1r7aetgS1vJPuTbR9tNoeT0BubHMLwh5Buwc2CsucgAismKMV0xKUVVfyLHoJsiFFefi2YGKi7l84J8zfmFMWgY6C9kAVoaLrg8JuP9nLZ96wZ6hxnbqY-BPmHKc6Z3ruujT_hnxtC-0svN4P7afaDTb6QPCd00Ypho9PR-dMNAH0Pv4z5rjTs3xRaHYR5coiuX2j7E0Z2QI--GjKfvd0ker68eVuvq5vbnr9XlTbXjwKaq7hxvhJJeas6NEVJ5h8aDbLXbeK5b04HAptsIzhopOo-eOWEkyNorr71YkrND7i7FUj9Pduzzvo4LGOdslamF1kYU8McH8CXOKZRuFgC4UEpDU6jv79S8GbGzu9SPLr3af28sAD8AuVhhi-m_GGb3W9nDVrZsZfdb2Vq8Ac4ShTM</recordid><startdate>20080901</startdate><enddate>20080901</enddate><creator>Abu-Hilal, M.</creator><creator>Primrose, J. N.</creator><creator>Casaril, A.</creator><creator>McPhail, M. J. W.</creator><creator>Pearce, N. W.</creator><creator>Nicoli, N.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20080901</creationdate><title>Surgical Resection Versus Radiofrequency Ablation in the Treatment of Small Unifocal Hepatocellular Carcinoma</title><author>Abu-Hilal, M. ; Primrose, J. N. ; Casaril, A. ; McPhail, M. J. W. ; Pearce, N. W. ; Nicoli, N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p210t-4da27365f582299356fae9f15c8abf28c9d13e7db320753dfef0a395154f6f8f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Cancer</topic><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Catheter Ablation - methods</topic><topic>Cohort Studies</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology</topic><topic>Hepatectomy - methods</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Kaplan-Meier Estimate</topic><topic>Liver cancer</topic><topic>Liver cirrhosis</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Staging</topic><topic>Original Article</topic><topic>Postoperative Complications - mortality</topic><topic>Probability</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Statistics, Nonparametric</topic><topic>Surgery</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abu-Hilal, M.</creatorcontrib><creatorcontrib>Primrose, J. N.</creatorcontrib><creatorcontrib>Casaril, A.</creatorcontrib><creatorcontrib>McPhail, M. J. W.</creatorcontrib><creatorcontrib>Pearce, N. W.</creatorcontrib><creatorcontrib>Nicoli, N.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abu-Hilal, M.</au><au>Primrose, J. N.</au><au>Casaril, A.</au><au>McPhail, M. J. W.</au><au>Pearce, N. W.</au><au>Nicoli, N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical Resection Versus Radiofrequency Ablation in the Treatment of Small Unifocal Hepatocellular Carcinoma</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2008-09-01</date><risdate>2008</risdate><volume>12</volume><issue>9</issue><spage>1521</spage><epage>1526</epage><pages>1521-1526</pages><issn>1091-255X</issn><eissn>1873-4626</eissn><abstract>Background
Hepatocellular carcinoma (HCC) has a high worldwide prevalence and mortality. While surgical resection and transplantation offers curative potential, donor availability and patient liver status and comorbidities may disallow either. Interventional radiological techniques such as radiofrequency ablation (RFA) may offer acceptable overall and disease-free survival rates.
Materials and Methods
Sixty-eight cirrhotic patients matched for age, sex, tumor size, and Child–Pugh grade with small (1–5 cm) unifocal HCC were studied retrospectively to find determinants of overall and disease-free survival in those treated with surgical resection and RFA between 1991 and 2003.
Results
Multivariate analysis using Cox proportional regression modeling showed that overall survival was related to tumor recurrence (
p
= 0.010), tumor diameter (
p
= 0.002), and treatment modality (
p
= 0.014); overall
p
= 0.008. Recurrence was independently related to the use of RFA over surgery (
p
= 0.023) on multivariate analysis; overall
p
= 0.034.
Conclusion
Surgical resection offers longer disease-free survival and potentially longer overall survival than RFA in patients with small unifocal HCC.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>18592325</pmid><doi>10.1007/s11605-008-0553-4</doi><tpages>6</tpages></addata></record> |
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| ispartof | Journal of gastrointestinal surgery, 2008-09, Vol.12 (9), p.1521-1526 |
| issn | 1091-255X 1873-4626 |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Aged Cancer Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - surgery Catheter Ablation - methods Cohort Studies Disease-Free Survival Female Follow-Up Studies Gastroenterology Hepatectomy - methods Humans Immunohistochemistry Kaplan-Meier Estimate Liver cancer Liver cirrhosis Liver Neoplasms - mortality Liver Neoplasms - pathology Liver Neoplasms - surgery Male Medicine Medicine & Public Health Middle Aged Mortality Multivariate Analysis Neoplasm Staging Original Article Postoperative Complications - mortality Probability Proportional Hazards Models Retrospective Studies Risk Assessment Statistics, Nonparametric Surgery Survival Analysis Treatment Outcome Tumors |
| title | Surgical Resection Versus Radiofrequency Ablation in the Treatment of Small Unifocal Hepatocellular Carcinoma |
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