Journal of gastroenterology and hepatology · 2025
Comparison of Surgical Resection and Radiofrequency Ablation for Early-Stage HCC Patients With Child-Pugh Class B.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Hatanaka Takeshi, Kakizaki Satoru, Hiraoka Atsushi, Tada Toshifumi, Kariyama Kazuya, Itobayashi Ei, Tsuji Kunihiko, Ishikawa Toru, Toyoda Hidenori, Koshiyama Yuichi, Naganuma Atsushi, Kanayama Yuki, Tanaka Kazunari, Tada Fujimasa, Ohama Hideko, Nouso Kazuhiro, Nakamura Shinichiro, Kumada Takashi, Real‐life Practice Experts for HCC (RELPEC) Study Group
Аннотация
AIM: The aim of this study is to compare the clinical outcomes of surgical resection (SR) and radiofrequency ablation (RFA) in patients with early-stage hepatocellular carcinoma (HCC) and Child-Pugh Class B liver function.
METHODS: Among 7210 treatment-naïve HCC patients in our group between 2000 and 2021, this retrospective study included 41 and 456 patients who underwent SR and RFA, respectively. All included patients had Child-Pugh Class B liver function, an Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2, and early-stage HCC (≤ 3 nodules, ≤ 3 cm in diameter). To adjust for baseline imbalances between the two groups, we applied inverse probability of treatment weighting (IPTW) analysis. Recurrence-free survival (RFS) and overall survival (OS) were assessed using Kaplan-Meier survival analysis and Cox regression models.
RESULTS: Before IPTW analysis, significant differences were observed between the SR and RFA groups in Child-Pugh scores (p = 0.003), total bilirubin levels (p = 0.04), prothrombin time (p = 0.003), and the presence of ascites (p = 0.01), all of which were more favorable in the SR group. The SR group also had fewer tumors (p = 0.03) and larger tumor diameters (p = 0.002) compared to the RFA group. In the entire cohort, there were no significant differences in RFS between the two groups (p = 0.6). After IPTW analysis, the differences remained statistically nonsignificant (p = 0.4). Regarding OS, the difference was not observed between the two groups in the entire cohort (p = 0.5) and in the IPTW cohort (p = 0.9).
CONCLUSION: RFA appears to be as effective as SR in patients with early-stage HCC with the liver function of Child-Pugh Class B.
METHODS: Among 7210 treatment-naïve HCC patients in our group between 2000 and 2021, this retrospective study included 41 and 456 patients who underwent SR and RFA, respectively. All included patients had Child-Pugh Class B liver function, an Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2, and early-stage HCC (≤ 3 nodules, ≤ 3 cm in diameter). To adjust for baseline imbalances between the two groups, we applied inverse probability of treatment weighting (IPTW) analysis. Recurrence-free survival (RFS) and overall survival (OS) were assessed using Kaplan-Meier survival analysis and Cox regression models.
RESULTS: Before IPTW analysis, significant differences were observed between the SR and RFA groups in Child-Pugh scores (p = 0.003), total bilirubin levels (p = 0.04), prothrombin time (p = 0.003), and the presence of ascites (p = 0.01), all of which were more favorable in the SR group. The SR group also had fewer tumors (p = 0.03) and larger tumor diameters (p = 0.002) compared to the RFA group. In the entire cohort, there were no significant differences in RFS between the two groups (p = 0.6). After IPTW analysis, the differences remained statistically nonsignificant (p = 0.4). Regarding OS, the difference was not observed between the two groups in the entire cohort (p = 0.5) and in the IPTW cohort (p = 0.9).
CONCLUSION: RFA appears to be as effective as SR in patients with early-stage HCC with the liver function of Child-Pugh Class B.