Comparison of 2 curative treatment options for very early hepatocellular carcinoma: Efficacy, recurrence pattern, and retreatment

Tae Hyung Kim, Jung Mi Chang, Soon Ho Um, Heejung Jee, Yoo Ra Lee, Han Ah Lee, Sun Young Yim, Na Yeon Han, Jae Min Lee, Hyuk Soon Choi, Eun Sun Kim, Young Dong Yu, Bora Keum, Min Ju Kim, Hyunggin An, Beom Jin Park, Yeon Seok Seo, Dong Sik Kim, Hyung Joon Yim, Sung Bum ChoYoon Tae Jeen, Hong Sik Lee, Hoon Jai Chun, Yun Hwan Kim, Chang Duck Kim

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Abstract

Curative treatments for very early-stage hepatocellular carcinoma (HCC), defined as single HCC with a maximum diameter of <2 cm in patients with well-preserved liver function, consist of surgical resection or radiofrequency ablation (RFA). In this retrospective study, we compared the efficacy of both treatments in 154 patients with very early-stage HCCs who underwent resection or RFA as initial therapy and were followed up for a median of 56.8 months. Propensity score matching analysis was also conducted. Overall survival was comparable between treatment groups (median survival time of 143 vs 97 months for resection and RFA, respectively; P = .132). Resection group; however, demonstrated a significantly lower recurrence rate after initial therapy than RFA group (42.3% vs 65.7%; P = .006) with a longer median recurrence-free survival time (66.7 vs 33.8 months; P = .002), which was confirmed even after matching (P = .04). In contrast, the recurrence pattern in advanced-stage (9.6% vs 1.0%; P = .01) or incurable recurrences (19% vs 13%; P = .04) was more frequent following resection than RFA. Recurrent lesions were comparatively more curable in RFA group than in resection group (80% vs 54.5%; P = .02). The recurrence of HCC was independently associated with lower serum albumin level (P = .027), the presence of comorbid diabetes mellitus (P = .010), and RFA (P = .034). In conclusion, in patients with very early-stage HCC, surgical resection has achieved significantly better recurrence-free survival than RFA. A closer follow-up is required after resection.

Original languageEnglish
Pages (from-to)e16279
JournalMedicine
Volume98
Issue number26
DOIs
Publication statusPublished - 2019 Jun 1

ASJC Scopus subject areas

  • Medicine(all)

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    Kim, T. H., Chang, J. M., Um, S. H., Jee, H., Lee, Y. R., Lee, H. A., Yim, S. Y., Han, N. Y., Lee, J. M., Choi, H. S., Kim, E. S., Yu, Y. D., Keum, B., Kim, M. J., An, H., Park, B. J., Seo, Y. S., Kim, D. S., Yim, H. J., ... Kim, C. D. (2019). Comparison of 2 curative treatment options for very early hepatocellular carcinoma: Efficacy, recurrence pattern, and retreatment. Medicine, 98(26), e16279. https://doi.org/10.1097/MD.0000000000016279