Combined resection and radiofrequency ablation for multifocal hepatocellular carcinoma: Prognosis and outcomes

Table 1 Reasons for adopting combination therapy n (%)

	Combination group (n = 19)
Bilobar disease	14 (73.6)
Proximity to major vessel or bile duct	5 (26.3)
Dense adhesion	3 (15.8)
Large resection required for small tumors	5 (26.3)
ICG rate at 15 min > 14.4%	5 (26.3)
Low platelet count (< 100 × 109/L)	3 (15.8)
Severe cirrhosis	9 (47.4)

ICG: Indocyanine green.

Table 2 Patient demographics

	Combination group (n = 19)	Resection group (n = 54)	P value
Age (yr)	65 (34-77)	52 (27-80)	0.003
Gender (M:F)	17:2	43:11	0.492
Comorbidities	10 (53%)	20 (37%)	0.235
Renal impairment	0 (0%)	2 (3.7%)	1.000
Diabetes mellitus	5 (26.3%)	10 (18.5%)	0.469
Chest infection	1 (5.3%)	3 (5.6%)	1.000
Coronary complications	6 (31.6%)	14 (25.9%)	0.635
Hepatitis B infection	16 (84.2%)	42 (77.8%)	0.745
Hepatitis C infection	2 (10.5%)	2 (3.7%)	0.478
Child-Pugh class A	19	54	1.000
Platelet count (× 109/L)	165 (91-64.5)	177 (86-458)	0.396
ICG (% at 15 min)	11.8 (3-25.7)	9 (3.7-18.2)	0.083
AFP level (ng/mL)	248 (6-38 040)	133 (2-530 600)	0.915
Tumor size (cm)	6 (1.2-14)	6 (1-12.5)	0.782
Tumor number	3 (2-9)	3 (2-9)	0.574

AFP: α-fetoprotein.

Table 3 Types of resection performed according to Brisbane terminology (2005) of liver resection n (%)

	Combination group (n = 19)	Resection group (n = 54)
Right hepatectomy	1 (5.3)	17 (31.5)
Extended right hepatectomy	0 (0)	6 (11.1)
Right trisectionectomy	0 (0)	2 (3.7)
Left hepatectomy	3 (15.8)	3 (5.6)
Extended left hepatectomy	2 (10.5)	4 (7.4)
Left trisectionectomy	0 (0)	3 (5.6)
Left lateral sectionectomy	3 (15.8)	1 (1.9)
Segmentectomy	1 (5.3)	11 (20.4)
Wedge resection of liver	9 (47.4)	7 (13)

Table 4 Histopathological results of tumors n (%)

	Combination group (n = 19)	Resection group (n = 54)	P value
Margin involvement	0 (0)	4 (7.4)	0.567
Vascular permeation	7 (36.8)	31 (57.4)	0.123
Microsatellite lesion	3 (15.8)	14 (25.9)	0.530
Poorly differentiated cell type	2 (10.5)	8 (14.8)	0.857
Complete ablation	19 (100)	-
Histological proof of HCC at ablation sites	19 (100)	-

HCC: Hepatocellular carcinoma.