Department of Gastroenterological Surgery, Hiroshima University Hospital 1-2-3, Kasumi, Hiroshima, Japan.
J Surg Oncol. 2011 Jul 1;104(1):3-9. doi: 10.1002/jso.21745.
The preferred choice between surgical treatment and radiofrequency ablation (RFA) for the treatment of small resectable hepatocellular [corrected] carcinoma (HCC) has become a subject for debate.
We compared the results of hepatic resection (n = 199) with those of RFA (n = 87), of which 69 patients were treated with transcatheter arterial chemoembolization followed by RFA, for 286 patients with 3 or fewer nodules, none of which exceeded 3 cm in diameter at Hiroshima University Hospital.
In subgroup analysis of single HCC with tumor size exceeding 2 cm in Child-Pugh class A, the disease-free survival time was significantly longer in the surgical resection group than in the RFA group (P = 0.048). In the subgroups of a single and multiple HCC with tumor size ≤2 cm in Child-Pugh class A, the overall and disease-free survival rates were almost the same for the surgical resection and RFA groups (P = 0.46 and 0.58, respectively, in single HCC, and P = 0.98 and 0.98, respectively, in multiple HCC).
Surgical resection may provide better long-term disease-free survival than RFA in the subgroup of a single HCC exceeding 2 cm of Child-Pugh class A.
对于治疗小的可切除肝细胞癌（HCC），手术治疗与射频消融（RFA）之间的首选方案一直存在争议。
我们比较了肝切除术（n=199）和 RFA（n=87）的结果，其中 69 例患者接受了经导管动脉化疗栓塞（TACE）联合 RFA 治疗，这些患者在广岛大学医院均有 3 个或更少的结节，且每个结节的直径均不超过 3cm。
在 Child-Pugh 分级为 A 的单个 HCC 且肿瘤直径超过 2cm 的亚组分析中，手术切除组的无疾病生存率明显长于 RFA 组（P=0.048）。在 Child-Pugh 分级为 A 的单个和多个 HCC 且肿瘤直径≤2cm 的亚组中，手术切除组和 RFA 组的总生存率和无疾病生存率几乎相同（在单个 HCC 中分别为 P=0.46 和 0.58，在多个 HCC 中分别为 P=0.98 和 0.98）。
在 Child-Pugh 分级为 A 的单个 HCC 超过 2cm 的亚组中，手术切除可能比 RFA 提供更好的长期无疾病生存率。
