Objective: To compare the effectiveness of percutaneous radiofrequency ablation (PRFA) and surgical resection as an initial treatment for patients with small hepatocellular carcinoma (HCC).
Methods: Between March 2000 and June 2003, 112 patients with small HCC (with single nodule less than 5 cm in diameter) were divided at random into two groups: resection group (n = 65) and PRFA group (n = 47) to undergo surgical resection or PRFA respectively.
Results: The 1-, 2- and 3-year recurrence rates were 10.7%, 18.4%, and 24.6% respectively in the 65 patients of the resection group and were 8.5%, 19.1%, and 23.4% respectively in the 47 patients of the PRFA group. The 1-, 2-, and 3-year survival rates were 93.18%, 85.69%, and 67.26% respectively in the 65 patients of the resection group and were 92.79%, 82.03%, and 64.46% respectively in the 47 patients of the PRFA group (P = 0.7534). The 1-, 2- and 3-year survival rates of the patients with tumor less than 3 cm in diameter were slightly higher in the PRFA group than in the resection group, however, insignificantly (P = 0.1253). The 1-, 2- and 3- year survival rates of the patients with tumor 3.1 to 5 cm in diameter were higher in the resection group than in the PRFA group, however, insignificantly (P = 0.4617). The 1, 2, and 3-year survival rates of the patients at stage Ia were slightly higher in the PRFA group than in the resection group, however, insignificantly (P = 0.1253). The 1, 2, and 3-year survival rates of the patients at stage Ib were slightly higher in the resection group than in the PRFA group, however, insignificantly (P = 0.4617).
Conclusion: PRFA treatment is a less invasive form of treatment for small HCC than surgical resection and is equally effective as the more invasive surgical resection. PRFA is superior to surgical resection when used in the treatment of patients with HCC less than 3 cm in diameter. PRFA can be used instead of surgical resection in proper situations.