Long-term analysis of a prospective randomized trial of hepatic resection versus radiofrequency ablation for early stage hepatocellular carcinoma

Abstract

Background: Both hepatic resection (HR) and radiofrequency ablation (RFA) are treatment of choice for early stage hepatocellular carcinoma (HCC). This prospective randomized study aims to test the hypothesis that RFA is superior than HR in terms of reduced tumor recurrence and better long–term survival. Methods: Two hundreds and eighteen patients with early stage HCC (tumor size ≤ 5cm and tumor nodules ≤ 3) were randomized into HR group (n = 109) and RFA group (n = 109). Primary and secondary outcome measure was overall tumor recurrence and patientsʼsurvival, respectively. Results: RFA group had significantly shorter treatment duration, less blood loss and shorted hospital stay when compared with HR group. The 1–year, 3–year, 5–year and 10–year overall survival rates for HR group and RFA group were 94.5%, 80.6%, 66.5%, 47.6% and 95.4%, 82.3%, 66.4%, 41.8%, respectively. Meanwhile, the 1–year, 3–year, 5–year and 10–year disease–free survival rates for HR group and RFA groups were 74.1%, 50.9%, 41.5%, 31.9% and 70.6%, 46.6%, 33.6%, 18. 6%, respectively. No statistical significant difference was found between 2 groups in overall and disease–free survival. Conclusion: Both HR and RFA are effective treatment modalities for early stage HCC in terms of similar overall survival and disease–free survival rates.