Is hepatic resection always a better choice than radiofrequency ablation for solitary hepatocellular carcinoma regardless of age and tumor size?

Shicong Zeng; Yao Zhang; Zongwen Wang; Xiaohang Ren; Jingtao Li; Shuoheng Ma; Wenyu Liu; Qiankun Zhu; Yan Yan; Bo Zhai

doi:10.17305/bb.2022.8507

Authors

Shicong Zeng Department of Surgical Oncology and Hepatobiliary Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China https://orcid.org/0000-0002-8252-3280
Yao Zhang Department of Surgical Oncology and Hepatobiliary Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
Zongwen Wang Department of Surgical Oncology and Hepatobiliary Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
Xiaohang Ren Department of Surgical Oncology and Hepatobiliary Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
Jingtao Li Department of Surgical Oncology and Hepatobiliary Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
Shuoheng Ma Department of Surgical Oncology and Hepatobiliary Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
Wenyu Liu Department of Surgical Oncology and Hepatobiliary Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
Qiankun Zhu Department of Intervention Radiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
Yan Yan Department of Intervention Radiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
Bo Zhai Department of Surgical Oncology and Hepatobiliary Surgery, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China https://orcid.org/0000-0002-8671-261X

DOI:

https://doi.org/10.17305/bb.2022.8507

Keywords:

Hepatocellular carcinoma, hepatic resection, radiofrequency ablation, tumor size, elderly, SEER

Abstract

In this study, we aimed to compare survival outcomes after receiving radiofrequency ablation (RFA) and hepatic resection (HR) for solitary hepatocellular carcinoma (HCC) with stratification by tumor size and age. A retrospective cohort was obtained from the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015. Patients were grouped by tumor size (0-2, 2-5, and > 5 cm) and age (>65 and ≤65). Overall survival (OS) and disease-specific survival (DSS) were assessed. For patients >65 with tumors measuring 0-2 and 2-5 cm, the HR group had better OS and DSS compared with the RFA group. For patients >65 with tumors > 5 cm, OS and DSS did not differ significantly between the RFA and HR groups (p = 0.262 and p = 0.129, respectively). For patients ≤65, the HR group had better OS and DSS compared with the RFA group regardless of tumor size. For patients with resectable solitary HCC, regardless of age, HR is the better choice not only for tumors ≤ 2 cm, but also for tumors 2-5 cm. For resectable solitary HCC with tumors ＞5 cm, HR is the better choice for patients ≤65 but for patients >65, the issue of treatment choice needs to be further studied.