S. Liu1, R. Hu1 1National Taiwan University Hospital,Department Of Surgery,Taipei City, TAIWAN, Taiwan
Introduction:
Hepatocellular carcinoma (HCC) was characterized with its high recurrence rate and poor long term prognosis. There was few study described the difference of HCC recurrent locations among different treatment. The present study aimed to compare the recurrent locations after the patients receiving curative surgical resection or receiving RFA.
Methods:
A total of 419 patients with single solitary HCC ≤ 5 cm who underwent curative-intent surgical resection (SR) or radiofrequency ablation (RFA) as initial treatment were retrospectively collected between January 2013 and December 2015. Electric medical charts and image were reviewed to collected clinical characteristics data and patterns of recurrence. Clinical follow-up of these patients were traced to December 2017, with the mean follow-up time 35.2 months. Recurrent locations were classified into recurrence occurred only in the same or nearby segment compared with primary tumor location, recurrence involved to distal segment, and recurrence involved extrahepatic recurrence. Other recurrence patterns including recurrent AFP, recurrent tumor number, time period to recurrence, and major vessels invasion were also collected. The recurrence patterns and outcomes were compared between the patients who received SR and the patients who received RFA.
Results:
There were 157 patients enrolled in SR group and 262 patients enrolled in RFA group. Comparing two treatment groups, the outcomes evaluation showed better overall survival (p = 0.001) and disease free survival (p< 0.001) in SR. Comparing the recurrence pattern, the RFA group showed significant higher rate in only same or nearby segment recurrence (SR: 29.5% vs RFA: 60.1%, p-value 0.001). The multivariate analysis identified receiving RFA as significant risk factor for same or nearby segment recurrence. There was no difference in other recurrence pattern between two groups.
Conclusion:
For HCC patients with single solitary tumor ≤ 5 cm, receiving RFA as initial treatment may have higher same or nearby recurrence rate compared to receiving SR as initial treatment