Background: Treatment outcomes of laparoscopic liver resection (LLR) and percutaneous radiofrequency ablation (p-RFA) for small single hepatocellular carcinomas (HCCs) have not yet been fully compared. The aim of this study was to compare LLR and p-RFA as first-line treatment options in patients with single nodular HCCs ≤3 cm. Methods: From January 2014 to December 2016, a total of 566 patients with single nodular HCC ≤3 cm treated by either LLR (n = 251) or p-RFA (n = 315) were included. The recurrence-free survival (RFS) and cumulative incidence of local tumor progression (LTP) were estimated using Kaplan-Meier methods and compared using the log-rank test. Treatment outcome of 2 treatment modalities was compared in the subgroup of patients according to the tumor location. Results: There were no significant differences in overall survival between LLR and p-RFA (p = 0.160); however, 3-year RFS was demonstrated to be significantly higher after LLR (74.4%) than after p-RFA (66.0%) (p = 0.013), owing to its significantly lower cumulative incidence of LTP (2.1% at 3 years after LLR vs. 10.0% after p-RFA, p #x3c; 0.001). The complication rate of p-RFA was significantly lower than that of LLR (5.1 vs. 10.0%, p = 0.026). LLR also provided significantly better local tumor control than p-RFA for subscapular tumors (3-year LTP rates: 1.9 vs. 8.8%, p = 0.012), perivascular tumors (3-year LTP rates: 0.0 vs. 17.2%, p = 0.007), and tumors located in anteroinfero-lateral liver portions (3-year LTP rates: 0.0 vs. 10.7%, p #x3c; 0.001). However, there were no significant differences in LTP rates between LLR and p-RFA for non-subcapsular and non-perivascular tumors (p = 0.482) and for tumors in postero-superior liver portions (p = 0.380). Conclusions: LLR can provide significantly better local tumor control than p-RFA for small single HCCs in subcapsular, perivascular, and anteroinferolateral liver portions and thus may be the preferred treatment option for these tumors.
Liver Cancer

中文翻译：

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腹腔镜肝切除与经皮射频消融治疗小型单结节性肝细胞癌：治疗结果比较

背景：腹腔镜肝切除术 (LLR) 和经皮射频消融术 (p-RFA) 治疗小型单一肝细胞癌 (HCC) 的治疗结果尚未得到充分比较。本研究的目的是比较 LLR 和 p-RFA 作为单发结节性 HCC ≤ 3 cm 患者的一线治疗选择。方法：从 2014 年 1 月至 2016 年 12 月，共有 566 例单结节性 HCC ≤3 cm 患者接受 LLR（ n = 251）或 p-RFA（ n= 315) 被包括在内。使用Kaplan-Meier方法估计无复发生存期（RFS）和局部肿瘤进展的累积发生率（LTP），并使用对数秩检验进行比较。根据肿瘤位置在患者亚组中比较了 2 种治疗方式的治疗结果。结果： LLR和p-RFA的总生存期无显着差异（p =0.160）；然而，LLR 后的 3 年 RFS (74.4%) 显着高于 p-RFA (66.0%) ( p = 0.013)，因为其 LTP 的累积发生率显着降低 (LLR 后 3 年为 2.1%)与 p-RFA 后的 10.0% 相比，p#x3c; 0.001)。p-RFA 的并发症发生率明显低于 LLR (5.1 vs. 10.0%, p = 0.026)。对于肩胛下肿瘤（3 年 LTP 率：1.9 对 8.8%，p = 0.012）、血管周围肿瘤（3 年 LTP 率：0.0 对 17.2%，p = 0.007）和位于前下外侧肝脏部分的肿瘤（3 年 LTP 率：0.0 对 10.7%，p #x3c；0.001）。然而，对于非包膜下和非血管周围肿瘤 ( p = 0.482) 和肝后上部肿瘤 ( p = 0.380)，LLR 和 p-RFA 之间的 LTP 率没有显着差异。结论：对于包膜下、血管周围和前下外侧肝脏部分的小单个 HCC，LLR 可以提供比 p-RFA 显着更好的局部肿瘤控制，因此可能是这些肿瘤的首选治疗选择。
肝癌