RF vs. SURGERY FOR HCC

• At a follow-up of 3 years, overall survival rates and disease-free survival rates were higher in patients treated with minimally invasive surgery vs radiofrequency ablation.
• Radiofrequency ablation was associated with higher rates of local recurrence vs minimally invasive surgery.
• However, radiofrequency ablation was associated with a lower incidence of postoperative complications, shorter surgery times, and shorter duration of hospital stay.

In a retrospective analysis published by Si et al in Surgical Endoscopy, researchers found minimally invasive surgery led to higher survival and lower local recurrence in patients with small hepatocellular carcinoma vs radiofrequency ablation, whereas radiofrequency ablation was associated with shorter operating times and hospitalization duration, as well as lower complication rates.
Researchers analyzed six retrospective studies that included a total of 597 patients with small hepatocellular carcinoma; 313 were treated with radiofrequency ablation, and 284 were treated with minimally invasive surgery. The team then evaluated overall survival, disease-free survival, local recurrence, complication rates, hospitalization duration, and operation times.
Findings
At a follow-up of 3 years, overall survival rates were higher in patients treated with minimally invasive surgery vs radiofrequency ablation (odds ratio [OR] = 0.55, 95% confidence interval [CI] = 0.36–0.84). At 3 years, disease-free survival rates were higher with minimally invasive surgery vs radiofrequency ablation (OR = 0.63, 95% CI = 0.41–0.98). Radiofrequency ablation was also associated with higher rates of local recurrence vs minimally invasive surgery (OR = 2.24, 95% CI = 1.47–3.42).
However, radiofrequency ablation was associated with a lower incidence of postoperative complications (OR = 0.34, 95% CI = 0.22–-0.53), shorter surgery times (OR = −145.31, 95% CI = −200.24 to −90.38), and shorter duration of hospital stay (OR = −4.02, 95% CI = −4.94 to −3.10).
Researchers concluded, “Considering long-term outcomes, minimally invasive surgery was found to be superior to radiofrequency ablation. However, radiofrequency ablation may be an alternative treatment for patients presenting a single small hepatocellular carcinoma nodule (≤ 3 cm), given its minimally invasive nature and its comparable long-term efficacy with minimally invasive surgery. Nevertheless, our findings should be explained with caution due to the low level of evidence obtained.”