Surgical vs percutaneous radiofrequency ablation for hepatocellular carcinoma in dangerous locations

Table 1 Dempgraphic parameters of patients undergoing percutaneous and surgical radiofrequency ablation

Parameters	Patients undergoing percutaneous RFA (n = 63)	Patients undergoing surgical RFA (n = 93)	P value
Age (yr)	57.8 ± 16.1	52.4 ± 11.7	0.531
Gender (M/F)	55/14	81/12	0.205
HBV infected	58	91	0.006
HCV infected	1	0
None-HBV&HCV	10	2
Liver cirrhosis	46	71	0.174
AST (IU/L)	47.3 ± 36.2	44.6 ± 33.8	0.311
ALT (IU/L)	42.3 ± 31.4	44.1 ± 19.6	0.354
TB (μmol/L)	15.4 ± 3.4	14.2 ± 5.6	0.601
ALB (g/L)	39.1 ± 9.8	41.7 ± 5.4	0.852
Child A/B	61/8	93/0	0.001
PLT (< 1011)	13	9	0.092
PT (> 15’)	6	14	0.224
Tumor number, 1/2/3	51/16/2	79/13/1	0.095
Tumor size (cm), > 3/ ≤ 3	11/78	23/85	0.099
Solitary HCC (cm), ≤ 3	39	62	0.188
Tumor in dangerous locations	73	95	0.242
AFP (ng/mL), ≤ 400/> 400/> 1210	13/41/15	17/60/16	0.000

Non-hepatitis B virus (HBV) & hepatitis C virus (HCV): Patients who were negative for HBV and HCV antibody but not for anti-HBs. RFA: Radiofrequency ablation; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; AFP: α fetoprotein; TB: Total bilirubin; PLT: Platelet; PT: Prothrombin time; ALB: Albumin.

Table 2 Locations of lesions in patients undergoing percataneous and surgical radiofrequency ablation

	RFA
	Percataneous (n = 89)	Surgical (n = 108)
Segment location
I	0	0
II	7	12
III	13	17
IV	9	12
V	10	14
VI	6	11
VII	12	20
VIII	12	7
Adjacent vessels or organs
PH	8	12
RHV	17	15
MHV	8	12
LHV	11	16
IVC	6	8
Heart	3	5
Stomach	9	17
Lung	15	2
R.Kidney	4	7
Colon	5	12
GB	3	2

P = 0.640 by Pearson χ² test for segment location and P = 0.054 by Pearson χ² test for adjacent vessels or organs. Lesion between segments was registered at the major location. n: Lesion number; RFA: Radiofrequency ablation; PH: Porta hepatis; RHV: Right hepatic vein; MHV: Middle hepatic vein; LHV: Left hepatic vein; IVC: Inferior vena cava; GB: Gall bladder.

Table 3 Major complications of radiofrequency ablation

Classification of complications	Percutaneous RFA (n = 69)	Surgical RFA (n = 93)	P value
Grade I
Analgesics requirement	17	58	0.000
Fever above 38.5°C	23	45	0.055
Grade II
Ascites	4	11	0.190
Persistent jaundice	2	0	0.315
Gastric hemorrhage	0	3	0.132
Grade III
Hydrothorax requiring drainage	5	9	0.586
Skin burn	1	0	0.244
Encapsulated effusion needing drainage	3	1	0.184
Grade IV
Partial hepatic infarction	1	3	0.471
Gastric perforation	1	0	0.244
Bile duct injury	5	1	0.040
Procedure-related hemorrhage	6	1	0.018
Malignant seeding	2	0	0.315

RFA: Radiofrequency ablation.

Table 4 Univarite and multivariate analysis of relative risks for local tumor progression

Variable	Univariate analysis	Multivariate analysis
	P value	Relative risk (95% CI)	P value
Percutaneous vs surgical RFA	0.000	14.315 (4.857-25.412)	0.000
Age (yr) (> 60 vs ≤ 60)	0.402
HBV- infected (Y vs N)	0.455
Child-Pugh (B vs A)	0.038
Albumin (IU/L), ≤ 35 vs > 35	0.233
Total bilirubin (mg/L), > 10 vs ≤ 10	0.010	8.124 (2.325-101.587)	0.012
Serum AFP (ng/mL), ≥ 400 vs < 400	0.019
Prothrombin time, ≤ 15’vs > 15’	0.512
Tumor size (cm), > 3 vs ≤ 3	0.003	11.741 (3.754-21.665)	0.005
Tumor number, multiple vs single	0.111

RFA: Radiofrequency ablation; HBV: Hepatitis B virus; AFP: α fetoprotein.