Outcome after hepatectomy versus percutaneous radiofrequency ablation for treatment of solitary hepatocellular carcinoma in Childs A cirrhotic patients

Abstract

Aim: Is to compare the short‐term outcome of hepatic resection and radiofrequency ablation (RFA) in two groups of patients with a solitary hepatocellular carcinoma (HCC) less than 5 cm in Childs A cirrhotic patients. Patients and methods: The study comprised 60 patients; 52 (86.7%) males and 8 (13.3%) females, with mean age 45.2 +/‐ 9.6, range 26‐67 years. The patients were randomized into 2 groups: Resection group (n = 28 patients) assigned to undergo hepatic resection and radiofrequency group (n = 32 patients) assigned to undergo RFA. The morbidity; hospital stay; overall survival; disease‐free survival; psychological and physical welfare of the patients were assessed during the follow up period. Results: Therewas non‐significant difference (P[0.05) in both groups as regards the morbidity (21.4%in resection group versus 15.6%in RFA group). The mean hospital stay was 7 +/‐ 2.9 in resection group and 1 +/‐ 1.2 inRFAgroup; with a significant shorter stay (P<0.001) in RFA group. Patients included in RFA group showed significantly increased scores of psychological and physical welfare compared to resection group (P<0.001). Subgroup analysis showed non significant difference between both groups as regards the 2 years overall survival&recurrencefree survival in tumours less than 3 cm. On the other hand, surgical resection was superior to RFA for 2 years overall survival & the recurrence‐ free survival in subgroup analyses for lesions[3 cm,<5 cm. Conclusion: In patients with Child A cirrhosis with solitary HCC[3 cm, RFA provided results with non‐significant difference to surgical resection with the advantages of being less invasive, shorter hospital stay, and better quality of life. While in tumours between 3 and 5 cm, surgical resection was superior to RFA having better overall survival and tumour‐free recurrence.