Affiliations: [a] Department of General, Visceral and Transplantation Surgery, Charité Virchow-Clinic, Berlin, Germany | [b] Department of General, Visceral, Vascular and Pediatric Surgery, Medical Faculty of the University of Saarland, Homburg/Saar, Germany
Correspondence:
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Address for correspondence: Robert M. Eisele M.D., Department of General, Visceral and Transplantation Surgery, Charité Virchow-Clinic, Augustenburger Pl. 1, 13353 Berlin, Germany. Tel.: +49 30 450 652 483; Fax: +49 30 450 552 930; E-mail: robert_m.eisele@charite.de.
Abstract: Background:Recurrence of hepatocellular carcinoma (HCC) after surgical treatment is a common problem. It can be treated by radiofrequency ablation (RFA) or repeated hepatic resection (HR). This report compares both in a retrospective, single-institution database. Patients and methods:A prospectively collected database was retrospectively analyzed. RFA was performed under ultrasound control using two different monopolar devices. All kinds of access were used: open surgical (n=10), percutaneous (n=13) and laparoscopic (n=4). HR was performed using an ultrasound aspiration device. Indication for a particular treatment was allocated on a case-by-case basis; the final decision was often made intraoperatively. Results:Survival after RFA (median 40 months) was similar compared to that after HR (48 months, p=0.641, logRank-test). Tumor-free survival was markedly impaired after RFA (15 vs. 29 months). This difference was however not significant (p=0.07, logRank-test). Both groups were different regarding occurrence of cirrhosis, maximal tumor size, time after initial diagnosis and duration of the procedure. Conclusion:In this non-randomized retrospective trial, survival and disease-free survival was not significantly different when compared between patients treated by RFA and HR. There was however a tendency towards a longer tumor-free survival in the resected patients.
