1. Laparoscopic surgery versus radiofrequency ablation for the treatment of single hepatocellular carcinoma ≤3 cm in the elderly: a propensity score matching analysis
- Author
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Taiga Wakabayashi, Patrick Pessaux, Riccardo Memeo, Nicola de’Angelis, Emanuele Felli, Tullio Piardi, Delgado F. Javier Briceno, Alexis Laurent, Antonio Rampoldi, Paolo Magistri, Giulio Cesare Vitali, Maria Conticchio, René Adam, Giacomo Assirati, Maximiliano Gelli, Ferdinando M. Anelli, Luca Aldrighetti, Daniel Cherqui, Antonella Delvecchio, Fabrizio Di Benedetto, Francesca Ratti, Conticchio, M., Delvecchio, A., Ratti, F., Gelli, M., Anelli, F. M., Laurent, A., Vitali, G. C., Magistri, P., Assirati, G., Felli, E., Wakabayashi, T., Pessaux, P., Piardi, T., Di Benedetto, F., De'Angelis, N., Javier Briceno, D. F., Rampoldi, A. G., Adam, R., Cherqui, D., Aldrighetti, L., and Memeo, R.
- Subjects
Laparoscopic surgery ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Radiofrequency ablation ,medicine.medical_treatment ,Resection ,law.invention ,law ,medicine ,Hepatectomy ,Humans ,Laparoscopic resection ,Propensity Score ,Aged ,Retrospective Studies ,Radiofrequency Ablation ,Hepatology ,business.industry ,Liver Neoplasms ,Gastroenterology ,Retrospective cohort study ,medicine.disease ,Surgery ,Treatment Outcome ,Hepatocellular carcinoma ,Propensity score matching ,Catheter Ablation ,Operative time ,Laparoscopy ,business - Abstract
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.
- Published
- 2022