Published online Mar 15, 2019. doi: 10.4251/wjgo.v11.i3.227
Peer-review started: October 23, 2018
First decision: November 29, 2018
Revised: December 12, 2018
Accepted: January 5, 2019
Article in press: January 6, 2019
Published online: March 15, 2019
Many studies have revealed that radiofrequency (RF) ablation is comparable to hepatic resection in terms of long-term survival for patients with early stage hepatocellular carcinoma (HCC). However, most studies have not taken into account the location of HCCs.
Our study attempted to analyze the effect of the subphrenic location of HCC on the long-term therapeutic outcomes after hepatic resection and RF ablation.
To compare the long-term therapeutic outcomes between hepatic resection vs percutaneous RF ablation for HCCs abutting the diaphragm.
A total of 143 Child-Pugh class A patients who had undergone hepatic resection (n = 80) or percutaneous RF ablation (n = 63) for an HCC (≤ 3 cm) abutting the right diaphragm were included. Therapeutic outcomes were compared.
Hepatic resection was an independent prognostic factor for disease-free survival (DFS) (P ≤ 0.001; hazard ratio, 0.352; 95%CI: 0.205, 0.605; with RF ablation as the reference category); however, treatment modality was not an independent prognostic factor for overall survival (OS). The local tumor progression rate was 46.6% at 5 years for the RF ablation group.
Although OS was not significantly different between patients who had undergone hepatic resection or percutaneous RF ablation for HCCs abutting the diaphragm, DFS was better in the hepatic resection group.
Further studies with large sample size and multicenter prospective studies are needed to confirm the conclusion of this study.