Brief Article
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World J Gastroenterol. Jan 7, 2011; 17(1): 123-129
Published online Jan 7, 2011. doi: 10.3748/wjg.v17.i1.123
Surgical vs percutaneous radiofrequency ablation for hepatocellular carcinoma in dangerous locations
Ji-Wei Huang, Roberto Hernandez-Alejandro, Kristopher P Croome, Lu-Nan Yan, Hong Wu, Zhe-Yu Chen, Pankaj Prasoon, Yong Zeng
Ji-Wei Huang, Lu-Nan Yan, Hong Wu, Zhe-Yu Chen, Pankaj Prasoon, Yong Zeng, Department of Hepato-Biliary-Pancreatic Surgery, Division of Liver Transplantation, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Roberto Hernandez-Alejandro, Kristopher P Croome, Department of Surgery, University of Western Ontario, Hepatobiliary and Liver Transplant Surgery, London Health Sciences Centre, London Ontario, N6A 4S2, Canada
Author contributions: Hernandez-Alejandro R and Croome KP designed the study; Huang JW, Yan LN, Wu H, Chen ZY, Prasoon P and Zeng Y performed the research; Huang JW, Zeng Y, Hernandez-Alejandro R and Croome KP made the analyses and wrote the article.
Correspondence to: Yong Zeng, MD, Department of Hepato-Biliary-Pancreatic Surgery, Division of Liver Transplantation, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. zengyongmd@gmail.com
Telephone: +86-28-85422475 Fax: +86-28-85422475
Received: August 2, 2010
Revised: October 11, 2010
Accepted: October 18, 2010
Published online: January 7, 2011
Abstract

AIM: To compare the long-term outcome of percutaneous vs surgical radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) in dangerous locations.

METHODS: One hundred and sixty-two patients with HCC in dangerous locations treated with percutaneous or surgical RFA were enrolled in this study. The patients were divided into percutaneous RFA group and surgical RFA group. After the patients were regularly followed up for a long time, their curative rate, hospital stay time, postoperative complications and 5-year local tumor progression were compared and analyzed.

RESULTS: No significant difference was observed in curative rate between the two groups (91.3% vs 96.8%, P = 0.841). The hospital stay time was longer and more analgesics were required while the incidence of bile duct injury and RFA-related hemorrhage was lower in surgical RFA group than in percutaneous RFA group (P < 0.05). The local progression rate of HCC in dangerous locations was significantly lower in surgical RFA group than in percutaneous RFA group (P = 0.05). The relative risk of local tumor progression was 14.315 in percutaneous RFA group.

CONCLUSION: The incidence of severe postoperative complications and local tumor progression is lower after surgical RFA than after percutaneous RFA.

Keywords: Hepatocellular carcinoma; Radiofrequency ablation; Liver cirrhosis; Recurrence; Local therapy