Comparison Of Laparoscopic Resection,Radiofrequency Ablation And Open Resection In The Treatment Of Hepatocellular Carcinoma

Three mainstream techniques-laparoscopic hepatectomy (LH), radiofrequency ablation (RFA) and open hepatectomy (OH) were compared in this study, in terms of their efficacy in the treatment of small hepatocellular carcinoma (HCC).A comparative study was performed within a total of94patients diagnosed with HCC in our hospital from2005-2010, who underwent LH (28), RFA (33) or OH (33). They were either with a single tumor lesion of less than5cm or up to two nodules with diameters less than3cm each. Outcomes were carefully evaluated throughout a3-year follow-up interval and statistically interpreted.The corresponding disease-free survival rates for the LH group, the RFA group and the OH group were64.3%,27.3%and75.8%, respectively. The3-year overall survival rates were85.7%,51.5%and84.8%for the three groups. The RFA group had significant shorter disease-free survival rate compared with two surgical groups (p-value=0.001) and significant shorter overall survival (p-value=0.005), while the LH group and the OH group had no difference in survival results. For patients younger than60years, surgical approaches offered better long-term overall survival prognosis (p-value=0.016). There were no statistically significant differences among the three groups in overall survival for elderly patients (p-value=0.104).Among patients with small HCC, laparoscopic hepatectomy and open hepatectomy may provide better curative effects than percutaneous RFA. Percutaneous RFA is more likely to be incomplete for the treatment of small HCC and lead to faster recurrence than surgical resections, while open or laparoscopic surgery may share similar therapeutic effects. For patients younger than60years old, especially, surgical resection may be the better choice over radiofrequency ablation. Background&Aims:Three mainstream techniques-laparoscopic hepatectomy (LH), radiofrequency ablation (RFA) and open hepatectomy (OH) were compared in this study, in terms of their efficacy in the treatment of small hepatocellular carcinoma (HCC).Methods:A comparative study was performed within a total of94patients diagnosed with HCC in our hospital from2005-2010, who underwent LH (28), RFA (33) or OH(33). They were either with a single tumor lesion of less than5cm or up to two nodules with diameters less than3cm each. Outcomes were carefully evaluated throughout a3-year follow-up interval and statistically interpreted.Results:The corresponding disease-free survival rates for the LH group, the RFA group and the OH group were64.3%,27.3%and75.8%, respectively. The3-year overall survival rates were85.7%,51.5%and84.8%for the three groups. The RFA group had significant shorter disease-free survival rate compared with two surgical groups (p-value=0.001) and significant shorter overall survival (p-value=0.005), while the LH group and the OH group had no difference in survival results. For patients younger than60years, surgical approaches offered better long-term overall survival prognosis (p-value=0.016). There were no statistically significant differences among the three groups in overall survival for elderly patients (p-value=0.104).Conclusions:Among patients with small HCC, laparoscopic hepatectomy and open hepatectomy may provide better curative effects than percutaneous RFA. Percutaneous RFA is more likely to be incomplete for the treatment of small HCC and lead to faster recurrence than surgical resections, while open or laparoscopic surgery may share similar therapeutic effects. For patients younger than60years old, especially, surgical resection may be the better choice over radiofrequency ablation.