Background

Laparoscopic liver resection (LLR) and radiofrequency ablation (RFA) represented potential treatments for patients with a single hepatocellular carcinoma (HCC) smaller than 3 cm. As the aging population soared, our study aimed to examine the advantage/drawback balance for these treatments, which should be reassessed in elderly patients.

Methods

A multicentric retrospective study compared 184 elderly patients (aged >70 years) (86 patients underwent LLR and 98 had RFA) with single ≤3 cm HCC, observed from January 2009 to January 2019.

Results

After propensity score matching (PSM), the estimated 1- and 3-year overall survival rates were 96.5 and 87.9% for the LLR group, and 94.6 and 68.1% for the RFA group (p = 0.001) respectively. The estimated 1- and 3-year disease-free survival rates were 92.5 and 67.4% for the LLR group, and 68.5 and 36.9% for the RFA group (p = 0.001). Patients with HCC of anterolateral segments were more often treated with laparoscopic resection (47 vs. 36, p = 0.04). The median operative time in the resection group was 205 min and 25 min in the RFA group (p = 0.01). Length of hospital stay was 5 days in the resection group and 3 days in the RFA group (p = 0.03).

Conclusion

Despite a longer length of hospital stay and operative time, LLR guarantees a comparable postoperative course and a better overall and disease-free survival in elderly patients with single HCC (≤3 cm), located in anterolateral segments.

中文翻译：

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腹腔镜手术与射频消融治疗老年≤3 cm单发肝细胞癌的倾向评分匹配分析

背景

腹腔镜肝切除术 (LLR) 和射频消融术 (RFA) 代表了小于 3 cm 的单个肝细胞癌 (HCC) 患者的潜在治疗方法。随着人口老龄化的飙升，我们的研究旨在检查这些治疗的优缺点平衡，应在老年患者中重新评估。

方法

一项多中心回顾性研究比较了 2009 年 1 月至 2019 年 1 月观察到的 184 名老年患者（年龄 >70 岁）（86 名患者接受 LLR，98 名接受 RFA）单发≤3 cm HCC。

结果

在倾向得分匹配 (PSM) 后，LLR 组的估计 1 年和 3 年总生存率分别为 96.5% 和 87.9%，RFA 组为 94.6% 和 68.1% (p = 0.001)。LLR 组的估计 1 年和 3 年无病生存率为 92.5% 和 67.4%，RFA 组为 68.5% 和 36.9% (p = 0.001)。前外侧节段 HCC 患者更常接受腹腔镜切除术治疗（47 对 36，p = 0.04）。切除组的中位手术时间为 205 分钟，RFA 组为 25 分钟（p = 0.01）。切除组的住院时间为 5 天，RFA 组为 3 天（p = 0.03）。

结论

尽管住院时间和手术时间较长，但 LLR 可确保位于前外侧节段的单发 HCC（≤3 cm）老年患者具有可比的术后病程以及更好的总体和无病生存率。