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, Hyonggin An, Beom Jin Park, Yeon Seok Seo, Dong-Sik Kim, Hyung Joon Yim, Sung Bum Cho & 5 others Yoon Tae Jeen, Hong Sik Lee, Hoon-Jai Chun, Yun Hwan Kim, Chang Duck Kim

Research output: Contribution to journalArticle

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

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Retreatment
Hepatocellular Carcinoma
Recurrence
Survival
Therapeutics
Propensity Score
Serum Albumin
Diabetes Mellitus
Retrospective Studies
Liver

ASJC Scopus subject areas

  • Medicine(all)

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Comparison of 2 curative treatment options for very early hepatocellular carcinoma : Efficacy, recurrence pattern, and retreatment. / Kim, Tae Hyung; Chang, Jung Mi; Um, Soon-Ho; Jee, Heejung; Lee, Yoo Ra; Lee, Han Ah; Yim, Sun Young; Han, Na Yeon; Lee, Jae Min; Choi, Hyuk Soon; Kim, Eun-Sun; Yu, Young-Dong; Keum, Bora; Kim, Min Ju; An, Hyonggin; Park, Beom Jin; Seo, Yeon Seok; Kim, Dong-Sik; Yim, Hyung Joon; Cho, Sung Bum; Jeen, Yoon Tae; Lee, Hong Sik; Chun, Hoon-Jai; Kim, Yun Hwan; Kim, Chang Duck.

In: Medicine, Vol. 98, No. 26, 01.06.2019, p. e16279.

Research output: Contribution to journalArticle

Kim, Tae Hyung ; Chang, Jung Mi ; Um, Soon-Ho ; Jee, Heejung ; Lee, Yoo Ra ; Lee, Han Ah ; Yim, Sun Young ; Han, Na Yeon ; Lee, Jae Min ; Choi, Hyuk Soon ; Kim, Eun-Sun ; Yu, Young-Dong ; Keum, Bora ; Kim, Min Ju ; An, Hyonggin ; Park, Beom Jin ; Seo, Yeon Seok ; Kim, Dong-Sik ; Yim, Hyung Joon ; Cho, Sung Bum ; Jeen, Yoon Tae ; Lee, Hong Sik ; Chun, Hoon-Jai ; Kim, Yun Hwan ; Kim, Chang Duck. / Comparison of 2 curative treatment options for very early hepatocellular carcinoma : Efficacy, recurrence pattern, and retreatment. In: Medicine. 2019 ; Vol. 98, No. 26. pp. e16279.
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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.",
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T1 - Comparison of 2 curative treatment options for very early hepatocellular carcinoma

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AU - Kim, Tae Hyung

AU - Chang, Jung Mi

AU - Um, Soon-Ho

AU - Jee, Heejung

AU - Lee, Yoo Ra

AU - Lee, Han Ah

AU - Yim, Sun Young

AU - Han, Na Yeon

AU - Lee, Jae Min

AU - Choi, Hyuk Soon

AU - Kim, Eun-Sun

AU - Yu, Young-Dong

AU - Keum, Bora

AU - Kim, Min Ju

AU - An, Hyonggin

AU - Park, Beom Jin

AU - Seo, Yeon Seok

AU - Kim, Dong-Sik

AU - Yim, Hyung Joon

AU - Cho, Sung Bum

AU - Jeen, Yoon Tae

AU - Lee, Hong Sik

AU - Chun, Hoon-Jai

AU - Kim, Yun Hwan

AU - Kim, Chang Duck

PY - 2019/6/1

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