Comparative safety and effectiveness of ultrasound-guided radiofrequency ablation combined with preoperative three-dimensional reconstruction versus surgical resection for solitary hepatocellular carcinoma of 3-5 cm

Objective: To investigate the safety and effectiveness of ultrasound-guided radiofrequency ablation (RFA) combined with preoperative three-dimensional (3D) reconstruction versus surgical resection for solitary hepatocellular carcinoma of 3-5 cm. Methods: The cohort of this retrospective study included 66 consecutive patients who underwent open hepatectomy (Surgery group) between January 2009 and December 2014, as well as 54 consecutive patients who underwent ultrasound-guided RFA combined with preoperative 3D reconstruction (RFA group) during the same period. Preoperative 3D reconstruction was performed using Myrian-XP-Liver software. The image fusion system was used to evaluate the RFA safety margin at 1 month after surgery. Kaplan-Meier analysis and the log-rank test were used to compare the recurrence and overall survival (OS) rates between the two treatment groups. Results: There were no significant differences in the baseline characteristics of the two groups. The complete ablation rate was 94.4% (51/53). As compared with surgical resection for solitary HCC of 3-5 cm, ultrasound-guided RFA combined with preoperative 3D reconstruction significantly reduced the morbidity of excessive pain, total complications, and infections (p < 0.001). A significant decrease in the duration of the hospital stay after treatment was also observed in the RFA group (t = 10.017, p < 0.001). There was no significant difference in the cumulative recurrence rate between the two groups. Kaplan-Meier analysis and the log-rank test revealed no significant difference in the OS rate between the two groups over a 3-year follow-up period. Conclusion: Ultrasound-guided RFA combined with preoperative 3D reconstruction appears to be a safe and effective therapeutic option for patients with solitary HCC of 3-5 cm.