Abstract
Background: Less invasiveness is an important consideration for the treatment of hepatocellular carcinoma (HCC) especially in patients with severe cirrhosis. Methods: Between April 2000 and September 2016, 100 patients with liver damage B underwent multimodal radiofrequency ablation (RFA; n = 62) or laparoscopic hepatic resection (Lap-HR; n = 38) for primary HCC as defined by the Milan criteria. We compared the operative outcomes and patients’ survival between the two groups. Results: The RFA group showed worse liver functions as indicated by indocyanine green retention rate (32.9 vs. 22.4%; p < 0.0001) and serum albumin value (3.3 vs. 3.6 g/dl; p = 0.0029). As expected, RFA was less invasive, as indicated by the differences in operation time (166 vs. 288 min.; p < 0.0001) and blood loss (8 vs. 377 g; p < 0.0001). There was no significant difference in the morbidity rate between the two groups; however, the duration of hospital stay of the RFA group was significantly shorter (7 vs. 11 days; p = 0.0002). There were no significant between-group differences regarding overall or disease-free survival. Conclusion: Multimodal RFA for HCC in patients with severe cirrhosis is associated with less invasiveness and shorter hospital stays, with no compromise in the patients’ survival. In patients with severe cirrhosis, it may be time to consider changing the standard treatment for primary HCC within the Milan criteria to multimodal RFA.
| Original language | English |
|---|---|
| Pages (from-to) | 46-51 |
| Number of pages | 6 |
| Journal | Surgical endoscopy |
| Volume | 33 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 15 2019 |
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All Science Journal Classification (ASJC) codes
- Surgery
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Multimodal radiofrequency ablation versus laparoscopic hepatic resection for the treatment of primary hepatocellular carcinoma within Milan criteria in severely cirrhotic patients : long-term favorable outcomes over 10 years. / Yamashita, Yo ichi; Imai, Katsunori; Kaida, Takayoshi; Yamao, Takanobu; Tsukamoto, Masayo; Nakagawa, Shigeki; Okabe, Hirohisa; Chikamoto, Akira; Ishiko, Takatoshi; Yoshizumi, Tomoharu; Ikeda, Tetsuo; Maehara, Yoshihiko; Baba, Hideo.
In: Surgical endoscopy, Vol. 33, No. 1, 15.01.2019, p. 46-51.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Multimodal radiofrequency ablation versus laparoscopic hepatic resection for the treatment of primary hepatocellular carcinoma within Milan criteria in severely cirrhotic patients
T2 - long-term favorable outcomes over 10 years
AU - Yamashita, Yo ichi
AU - Imai, Katsunori
AU - Kaida, Takayoshi
AU - Yamao, Takanobu
AU - Tsukamoto, Masayo
AU - Nakagawa, Shigeki
AU - Okabe, Hirohisa
AU - Chikamoto, Akira
AU - Ishiko, Takatoshi
AU - Yoshizumi, Tomoharu
AU - Ikeda, Tetsuo
AU - Maehara, Yoshihiko
AU - Baba, Hideo
PY - 2019/1/15
Y1 - 2019/1/15
N2 - Background: Less invasiveness is an important consideration for the treatment of hepatocellular carcinoma (HCC) especially in patients with severe cirrhosis. Methods: Between April 2000 and September 2016, 100 patients with liver damage B underwent multimodal radiofrequency ablation (RFA; n = 62) or laparoscopic hepatic resection (Lap-HR; n = 38) for primary HCC as defined by the Milan criteria. We compared the operative outcomes and patients’ survival between the two groups. Results: The RFA group showed worse liver functions as indicated by indocyanine green retention rate (32.9 vs. 22.4%; p < 0.0001) and serum albumin value (3.3 vs. 3.6 g/dl; p = 0.0029). As expected, RFA was less invasive, as indicated by the differences in operation time (166 vs. 288 min.; p < 0.0001) and blood loss (8 vs. 377 g; p < 0.0001). There was no significant difference in the morbidity rate between the two groups; however, the duration of hospital stay of the RFA group was significantly shorter (7 vs. 11 days; p = 0.0002). There were no significant between-group differences regarding overall or disease-free survival. Conclusion: Multimodal RFA for HCC in patients with severe cirrhosis is associated with less invasiveness and shorter hospital stays, with no compromise in the patients’ survival. In patients with severe cirrhosis, it may be time to consider changing the standard treatment for primary HCC within the Milan criteria to multimodal RFA.
AB - Background: Less invasiveness is an important consideration for the treatment of hepatocellular carcinoma (HCC) especially in patients with severe cirrhosis. Methods: Between April 2000 and September 2016, 100 patients with liver damage B underwent multimodal radiofrequency ablation (RFA; n = 62) or laparoscopic hepatic resection (Lap-HR; n = 38) for primary HCC as defined by the Milan criteria. We compared the operative outcomes and patients’ survival between the two groups. Results: The RFA group showed worse liver functions as indicated by indocyanine green retention rate (32.9 vs. 22.4%; p < 0.0001) and serum albumin value (3.3 vs. 3.6 g/dl; p = 0.0029). As expected, RFA was less invasive, as indicated by the differences in operation time (166 vs. 288 min.; p < 0.0001) and blood loss (8 vs. 377 g; p < 0.0001). There was no significant difference in the morbidity rate between the two groups; however, the duration of hospital stay of the RFA group was significantly shorter (7 vs. 11 days; p = 0.0002). There were no significant between-group differences regarding overall or disease-free survival. Conclusion: Multimodal RFA for HCC in patients with severe cirrhosis is associated with less invasiveness and shorter hospital stays, with no compromise in the patients’ survival. In patients with severe cirrhosis, it may be time to consider changing the standard treatment for primary HCC within the Milan criteria to multimodal RFA.
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U2 - 10.1007/s00464-018-6264-3
DO - 10.1007/s00464-018-6264-3
M3 - Article
C2 - 29872945
AN - SCOPUS:85048061263
VL - 33
SP - 46
EP - 51
JO - Surgical Endoscopy
JF - Surgical Endoscopy
SN - 0930-2794
IS - 1
ER -