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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
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.
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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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