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Surgical resection versus ablation for hepatocellular carcinoma ≤ 3 cm: a population-based analysis.
- Source :
-
HPB . Oct2015, Vol. 17 Issue 10, p896-901. 6p. - Publication Year :
- 2015
-
Abstract
- Background Ablation for ≤ 3-cm hepatocellular carcinoma ( HCC) has been demonstrated to be an effective treatment strategy. The present study sought to examine the outcomes of patients with ≤3 cm HCC after ablation versus resection. Methods Patients treated by ablation or surgical resection for ≤ 3 cm T1 HCC were identified from the National Cancer Database (2002-2011). Survival outcomes were analysed according to propensity score modelling. Results A total of 2804 patients underwent ablation ( n = 1984) or a resection ( n = 820) for solitary HCC ≤ 3 cm. Patients treated with ablation as compared with a resection had a higher frequency in alpha-fetoprotein level (AFP) elevation (46.5% versus 39.1%, P < 0.01) and the presence of cirrhosis (22.2% versus 14.5%, P < 0.01). Unadjusted overall survival ( OS) at 3 and 5 years was greater after a resection (67%, 55%) versus ablation (52%, 36%, P < 0.01). After propensity score matching, the improved overall survival (OS) was sustained among the resection cohort (5 year OS: 54% versus 37%, P < 0.001). In multivariable models, a resection was independently associated with an improved OS [hazard ratio ( HR): 0.62, 95% confidence interval (CI): 0.48-0.81; P < 0.01]. Conclusion Resection of HCC ≤ 3 cm results in better long-term survival as compared with ablation. Treatment strategies for small solitary HCC should emphasize a resection first approach, with ablation being reserved for patients precluded from surgery. [ABSTRACT FROM AUTHOR]
- Subjects :
- *LIVER cancer
*ABLATION techniques
*LIVER surgery
*CANCER patients
*SURGERY
Subjects
Details
- Language :
- English
- ISSN :
- 1365182X
- Volume :
- 17
- Issue :
- 10
- Database :
- Academic Search Index
- Journal :
- HPB
- Publication Type :
- Academic Journal
- Accession number :
- 109463772
- Full Text :
- https://doi.org/10.1111/hpb.12446