Purpose

We aimed to compare the efficacy of hepatic resection and percutaneous ablation for resectable caudate HCC within Milan criteria and to investigate the prognostic factors.

Methods

Between August 2006 and August 2020, a total of 67 eligible patients with resectable caudate HCC within Milan criteria in three centers were retrospectively analyzed and divided into hepatic resection group (n = 46) and percutaneous ablation group (n = 21). Recurrence-free survival (RFS) and overall survival (OS) rates were compared between groups of hepatic resection and percutaneous ablation for these resectable caudate HCC patients with Kaplan–Meier curves and log-rank test. Univariable and multivariable Cox regression analyses were performed to identify the prognostic factors of RFS and OS.

Results

The 1-, 3-, and 5-year OS rates were 97.6%, 83.6%, and 71.5% for the hepatic resection group, and 89.4%, 58.5%, and 48.8% for the percutaneous ablation group (P = 0.032). The corresponding RFS rates were 77.6%, 47.9%, and 42.6% for the hepatic resection group, and 40.5%, 23.2%, and 15.4% for the percutaneous ablation group (P = 0.010). According to the univariable and multivariable analyses, tumor type (first recurrence) (HR = 3.54; 95%CI, 1.49–8.37; P = 0.004) was a significant independent prognostic factor of RFS for caudate HCC patients after resection or ablation, while total bilirubin (HR = 1.02; 95%CI, 1.01–1.04; P = 0.006) and treatment strategy (HR = 5.97; 95%CI, 1.48–24.12; P = 0.012) were significant independent prognostic factors of OS.

Conclusions

Hepatic resection appears to outperform percutaneous ablation for caudate HCC patients within Milan criteria.

中文翻译：

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米兰标准内尾状叶肝细胞癌肝切除与经皮消融的比较

目的

我们的目的是比较米兰标准下肝切除和经皮消融对可切除尾状 HCC 的疗效，并研究预后因素。

方法

2006年8月至2020年8月，回顾性分析了三个中心共67例符合米兰标准的可切除尾状HCC患者，分为肝切除组（n  = 46）和经皮消融组（n  = 21）。采用 Kaplan-Meier 曲线和对数秩检验比较了这些可切除尾状 HCC 患者的肝切除组和经皮消融组的无复发生存期 (RFS) 和总生存期 (OS) 率。进行单变量和多变量 Cox 回归分析以确定 RFS 和 OS 的预后因素。

结果

肝切除组1、3、5年OS率分别为97.6%、83.6%和71.5%，经皮消融组分别为89.4%、58.5%和48.8%（P  =0.032）。肝切除组相应的RFS率为77.6%、47.9%、42.6%，经皮消融组为40.5%、23.2%、15.4%（P  =0.010）。根据单变量和多变量分析，肿瘤类型（首次复发）（HR = 3.54；95%CI，1.49-8.37；P  = 0.004）是尾状 HCC 患者切除或消融后 RFS 的重要独立预后因素，而总胆红素 (HR = 1.02; 95%CI, 1.01–1.04; P  = 0.006) 和治疗策略 (HR = 5.97; 95%CI, 1.48–24.12; P = 0.012) 是 OS 的重要独立预后因素。

结论

对于米兰标准内的尾状 HCC 患者，肝切除似乎优于经皮消融。