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Comparison of 2 curative treatment options for very early hepatocellular carcinoma: Efficacy, recurrence pattern, and retreatment
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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6616374/ https://www.ncbi.nlm.nih.gov/pubmed/31261600 http://dx.doi.org/10.1097/MD.0000000000016279 |
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author | 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, Hyunggin 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 |
author_facet | 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, Hyunggin 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 |
author_sort | Kim, Tae Hyung |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6616374 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-66163742019-07-22 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, Hyunggin 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 Medicine (Baltimore) Research Article 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. Wolters Kluwer Health 2019-06-28 /pmc/articles/PMC6616374/ /pubmed/31261600 http://dx.doi.org/10.1097/MD.0000000000016279 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | Research Article 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, Hyunggin 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 |
title | Comparison of 2 curative treatment options for very early hepatocellular carcinoma: Efficacy, recurrence pattern, and retreatment |
title_full | Comparison of 2 curative treatment options for very early hepatocellular carcinoma: Efficacy, recurrence pattern, and retreatment |
title_fullStr | Comparison of 2 curative treatment options for very early hepatocellular carcinoma: Efficacy, recurrence pattern, and retreatment |
title_full_unstemmed | Comparison of 2 curative treatment options for very early hepatocellular carcinoma: Efficacy, recurrence pattern, and retreatment |
title_short | Comparison of 2 curative treatment options for very early hepatocellular carcinoma: Efficacy, recurrence pattern, and retreatment |
title_sort | comparison of 2 curative treatment options for very early hepatocellular carcinoma: efficacy, recurrence pattern, and retreatment |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6616374/ https://www.ncbi.nlm.nih.gov/pubmed/31261600 http://dx.doi.org/10.1097/MD.0000000000016279 |
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