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J Cancer 2019; 10(17):3933-3940. doi:10.7150/jca.29501 This issue Cite

Research Paper

Surgical Resection plus Radiofrequency Ablation versus Radical Surgery for Hepatocellular Carcinoma: A Propensity Score Matching Analysis

Cheng Zhou^1*, Xiangyu Zhang^1*, Yuanfei Peng^1*, Kaiqian Zhou¹, Jie Hu¹, Lei Yu¹, Feiyu Chen¹, Shuangjian Qiu¹, Jian Zhou^1,2,3, Jia Fan^1,2,3, Lan Zhang^1✉, Zheng Wang^1✉

1. Liver Cancer Institute, Zhongshan Hospital, Fudan University; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Fudan University, Shanghai, China
2. Institute of Biomedical Sciences, Fudan University, Shanghai, China
3. State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, China
*These authors contributed equally to this work.

✉ Corresponding authors: Dr. Zheng Wang, Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai, 200030, China. Phone number: 86-13817390051, E-mail: wang.zhengsh.cn; wzdoccom or to Dr. Lan Zhang, Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai, 200030, China. Phone number: 86-13918876432, E-mail: zhang.lansh.cn. More

Abstract

Objective: To evaluate the efficacy and safety of surgical resection plus radiofrequency ablation (SR-RFA) for multifocal hepatocellular carcinoma (HCC) with 2 or 3 nodules compared with surgical resection (SR).

Method: We retrospectively evaluated 824 consecutive HCC patients (SR, n = 754; SR-RFA, n = 70) from January 2009 to December 2015 and performed propensity score matching (PSM) to adjust for patient imbalances at a ratio of 1:4.

Results: At baseline, patients in the SR-RFA group had a smaller tumour size and worse liver function (including more ascites, a higher total bilirubin level, and a longer prothrombin time) than patients in the SR group. However, the two groups had similar overall survival (OS) and recurrence-free survival (RFS) rates (P = 0.209 and P = 0.332). The local recurrence rate of the SR-RFA group was significantly higher than that of the SR group (25.71% and 14.32%, P = 0.011). More patients in the SR-RFA group had postoperative complications (P = 0.003). In the propensity model, there was no intergroup difference in OS or RFS (P = 0.229 and P = 0.311, respectively).

Conclusion: SR-RFA provides a similar long-term survival to that on SR in HCC patients with 2 or 3 nodules, and its application should be carefully considered.

Keywords: hepatocellular carcinoma, radiofrequency ablation, surgical resection, survival rate, tumour recurrence

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