Research Report
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World J Gastroenterol. Apr 14, 2014; 20(14): 4059-4065
Published online Apr 14, 2014. doi: 10.3748/wjg.v20.i14.4059
Single hepatocellular carcinoma ≤ 3 cm in left lateral segment: Liver resection or radiofrequency ablation?
Jong Man Kim, Tae Wook Kang, Choon Hyuck David Kwon, Jae-Won Joh, Justin Sangwook Ko, Jae Berm Park, Hyunchul Rhim, Joon Hyeok Lee, Sung Joo Kim, Seung Woon Paik
Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Jae Berm Park, Sung Joo Kim, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea
Tae Wook Kang, Hyunchul Rhim, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea
Justin Sangwook Ko, Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea
Joon Hyeok Lee, Seung Woon Paik, Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea
Author contributions: Kim JM and Kang TW contributed equally to this work; Kim JM, Kang TW, Rhim H and Joh JW studied design; Kim JM, Kang TW, Park JB and Kwon CHD acquired of data; Kim JM and Kang TW analyzed of data; Kim JM, Kang TW, Kim SJ, Rhim H and Joh JW interpreted of data; Kim JM and Kang TW wrote the manuscript; Rhim H and Joh JW final approved of the version to be published; Ko JS, Lee JH and Paik SW drafted the article or revised it critically for important intellectual content.
Correspondence to: Jae-Won Joh, MD, PhD, Professor, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-Dong Gangnam-Gu, Seoul 135-710, South Korea. jw.joh@samsung.com
Telephone: +82-2-34103466 Fax: +82-2-34100040
Received: September 28, 2013
Revised: December 23, 2013
Accepted: January 3, 2014
Published online: April 14, 2014
Processing time: 197 Days and 13.4 Hours
Abstract

AIM: To evaluate the long-term results of radiofrequency ablation (RFA) compared to left lateral sectionectomy (LLS) in patients with Child-Pugh class A disease for the treatment of single and small hepatocellular carcinoma (HCC) in the left lateral segments.

METHODS: We retrospectively reviewed the data of 133 patients with single HCC (≤ 3 cm) in their left lateral segments who underwent curative LLS (n = 66) or RFA (n = 67) between 2006 and 2010.

RESULTS: The median follow-up period was 33.5 mo in the LLS group and 29 mo in the RFA group (P = 0.060). Most patients had hepatitis B virus-related HCC. The hospital stay was longer in the LLS group than in the RFA group (8 d vs 2 d, P < 0.001). The 1-, 2-, and 3-year disease-free survival and overall survival rates were 80.0%, 68.2%, and 60.0%, and 95.4%, 92.3%, and 92.3%, respectively, for the LLS group; and 80.8%, 59.9%, and 39.6%, and 98.2%, 92.0%, and 74.4%, respectively, for the RFA group. The disease-free survival curve and overall survival curve were higher in the LLS group than in the RFA group (P = 0.012 and P = 0.013, respectively). Increased PIVKA-II levels and small tumor size were associated with HCC recurrence in multivariate analysis.

CONCLUSION: Liver resection is suitable for single HCC ≤ 3 cm in the left lateral segments.

Keywords: Small hepatocellular carcinoma; Left lateral segment; Radiofrequency ablation; Liver resection; Tumor recurrence; Survival

Core tip: Many papers have reported the relative outcomes between liver resection and radiofrequency ablation, but here we selected patients with small and single hepatocellular carcinoma (HCC) in the left lateral segments. The present study showed that the disease-free survival curve and the overall survival curve were higher in the left lateral sectionectomy (LLS) group than in the radiofrequency ablation (RFA) group for those patients. However, the hospital stay was longer for the LLS group than for the RFA group. We conclude that liver resection is suitable for single HCC ≤ 3 cm in the left lateral segments.