Percutaneous radiofrequency ablation versus partial hepatectomy for multicentric small hepatocellular carcinomas: a...

Area of Science:

• Hepatobiliary Surgery
• Interventional Radiology
• Oncology

Background:

• Multicentric small hepatocellular carcinomas (HCCs) present treatment challenges.
• Percutaneous radiofrequency ablation (RFA) is a minimally invasive option for HCC.
• Comparing RFA with partial hepatectomy (PH) is crucial for optimizing HCC management.

Purpose of the Study:

• To compare the efficacy and safety of percutaneous RFA versus PH for multicentric small HCCs.
• To evaluate survival outcomes and complication rates between RFA and PH treatments.
• To determine the optimal treatment strategy for patients with multiple small HCCs.

Main Methods:

• A study included 159 patients with 2-3 HCCs (largest tumor ≤5 cm) without vascular invasion or metastases.
• Patients were treated with either partial hepatectomy (PH, n=73) or radiofrequency ablation (RFA, n=86).
• Outcomes assessed included survival rates, morbidity, and hospital stay duration.

Main Results:

• No procedure-related mortality occurred in either group.
• Major complications were significantly higher after PH (19.2%) compared to RFA (8.1%).
• PH demonstrated superior 1-, 3-, and 5-year overall survival (91.8%, 68.7%, 44.5%) and disease-free survival (62.1%, 33.6%, 3.6%) versus RFA (94.2%, 64.4%, 21.2% and 29.4%, 2.7%, 0%, respectively).

Conclusions:

• Partial hepatectomy (PH) yields better overall and disease-free survival for multicentric small HCCs.
• Radiofrequency ablation (RFA) offers significant advantages in reduced morbidity and shorter hospital stays.
• Treatment choice for multicentric small HCCs should balance survival benefits with procedural risks and recovery time.