Wu Fang, Wei Chao, Zhang Shicun, Jia Shanshan, Zhang Jidong
Department of Gastroenterology, School of Clinical Medical, Jiamusi University, Jiamusi, 154007, Heilongjiang Province, China.
Department of Medical Oncology, The Seventh Hospital of Qiqihar, Qiqihar, 161000, Heilongjiang Province, China.
Gastroenterol Res Pract. 2023 Feb 21;2023:1269504. doi: 10.1155/2023/1269504. eCollection 2023.
There is controversy regarding whether patients with single hepatocellular carcinoma (HCC) should be offered radiofrequency ablation (RFA) as a first-line treatment option. Thus, this study compared overall survival after surgical resection (SR) and RFA for single HCC.
The Surveillance, Epidemiology, and End Results (SEER) database was used for this retrospective study. The study included 30- to 84-year-old patients diagnosed with HCC from 2000 to 2018. Selection bias was reduced via propensity score matching (PSM). The study compared the overall survival (OS) and cancer-specific survival (CSS) of patients with single HCC who were treated with SR and RFA.
Before and after PSM, the median OS and median CSS were significantly longer in the SR group than in the RFA group ( < 0.05). In the subgroup analysis, the median OS and median CSS for male and female patients with male and female patients with tumor sizes <3, 3-5, and>5 cm, age at diagnosis between 60 and 84 years, and grades I-IV tumors were longer than in the SR group than in the RFA group ( < 0.05). Similar results were reported for patients who received chemotherapy ( < 0.05). Univariate and multivariate analyses revealed that compared with RFA, SR was an independent favorable factor for OS and CSS ( < 0.05) before and after PSM.
Patients with SR who had a single HCC showed higher OS and CSS compared with patients who received RFA. Hence, SR should be used as a first-line treatment in cases of single HCC.
对于单发肝细胞癌（HCC）患者是否应将射频消融（RFA）作为一线治疗方案存在争议。因此，本研究比较了单发HCC患者手术切除（SR）和RFA后的总生存期。
本回顾性研究使用监测、流行病学和最终结果（SEER）数据库。研究纳入了2000年至2018年诊断为HCC的30至84岁患者。通过倾向评分匹配（PSM）减少选择偏倚。该研究比较了接受SR和RFA治疗的单发HCC患者的总生存期（OS）和癌症特异性生存期（CSS）。
在PSM前后，SR组的中位OS和中位CSS均显著长于RFA组（<0.05）。在亚组分析中，肿瘤大小<3 cm、3 - 5 cm和>5 cm的男性和女性患者，诊断时年龄在60至84岁之间，以及I - IV级肿瘤的男性和女性患者，其SR组的中位OS和中位CSS均长于RFA组（<0.05）。接受化疗的患者也报告了类似结果（<0.05）。单因素和多因素分析显示，与RFA相比，PSM前后SR都是OS和CSS的独立有利因素（<0.05）。
与接受RFA的患者相比，接受SR治疗的单发HCC患者表现出更高的OS和CSS。因此，SR应作为单发HCC病例的一线治疗方法。
