Ng KKC, et al. - This randomized trial tested the hypothesis that radiofrequency ablation (RFA) is superior to hepatic resection in terms of lower tumour recurrence rate and better long-term survival. Non-superiority of RFA to hepatic resection for early-stage hepatocellular carcinoma (HCC) was demonstrated with respect to tumour recurrence, overall survival, and disease-free survival.

Methods

• Patients with early-stage HCC (solitary tumour no larger than 5cm; or no more than 3 tumours, each 3cm or smaller) were randomized into hepatic resection and RFA groups.
• Demographic and clinical characteristics and short- and long-term outcome measures between groups were compared.
• Overall tumour recurrence and survival were the primary and secondary outcome measures, respectively.

Results

• The two groups were similar with respect to clinicopathologic data; each group contained 109 patients.
• Compared to the resection group, the RFA group had a shorter treatment duration, less blood loss, and shorter hospital stay.
• The two groups were similar in terms of mortality and morbidity rates.
• In the resection and RFA groups, the overall tumour recurrence rate was similar (71·3% vs. 81·7% respectively).
• In the resection group, the 1-, 3-, 5-, and 10-year overall survival rates were 94·5%, 80·6%, 66·5%, and 47·6% respectively, compared with 95·4%, 82·3%, 66·4%, and 41·8%, respectively, in the RFA group (P=0·531).
• In the resection group, corresponding disease-free survival rates were 74·1%, 50·9%, 41·5%, and 31·9%, respectively, and 70·6%, 46·6%, 33·6%, and 18·6% in the RFA group, respectively (P=0·072).