Surgical resection superior to radiofrequency ablation for small perivascular HCC
Surgical resection (SR) as a first-line treatment for small perivascular hepatocellular carcinoma (HCC) provides better long-term tumour control than radiofrequency ablation (RFA), a recent study has shown.
Researchers performed a retrospective study of 283 consecutive small perivascular HCC patients who received either SR (n=182; mean age 53.8±9.2 years; 77.5 percent male) or RFA (n=101; mean age 57.0±10.0 years; 77.2 percent male) first-line treatment. Progression-free survival (PFS) and overall survival (OS) were compared between the two groups.
After propensity score matching (n=62 for each group), those who received SR showed significantly better survival than their RFA counterparts. The 3-, 5-, 7- and 10-year PFS rates were 68.7 percent, 58.0 percent, 56.0 percent and 17.8 percent in the SR group and 41.2 percent, 25.4 percent, 14.1 percent and 14.1 percent in the RDFA group, respectively (p<0.001).
A similar trend was observed for the 3-, 5-, 7- and 10-year OS rates, which were 98.4 percent, 93.5 percent, 91.9 percent and 91.9 percent in the SR group, and 91.9 percent, 82.3 percent, 74.1 percent and 74.1 percent in the RFA group, respectively (p<0.001).
Multivariate analysis of all patients showed that RFA was a significant predictor of poor PFS (hazard ratio [HR], 2.26; 95 percent CI, 1.52–3.35; p<0.001) and OS (HR, 2.25; 1.14–4.46; p=0.02).
Notably, the beneficial advantage of SR over RFA on OS was attenuated in patients with perivenous HCC (p=0.978), indicating that clinicians should take tumour location and type of peritumoural vessels into consideration when prescribing first-line treatments, said researchers.