Outcome after Hepatectomy versus percutaneous ablation for treatment of solitary hepatocellular carcinoma in Childs A cirrhotic patients
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Aim: is to compare the short-term outcome of hepatic resection and radiofrequency ablation (RFA) in two groups of patients with a single hepatocellular carcinoma (FICC) less than 5 cm in Childs A cirrhotic patients. Patients and Methods: The study comprised 60 patients; 52 (86.7%) males and 8 (13.3%) females, with mean age 45.2±9.6, range 26-67 years. The patients were randomized into 2 groups: Resection group (n=28 patients) assigned to undergo hepatic resection and radiofrequency group (n= 32 patients) assigned to undergo RFA. The morbidity; hospital stay; overall survival; disease-free survival; psychological and physical welfare of the patients were assessed during the follow up period. Results: There was non-significant difference (P>0.05) in both groups as regards the morbidity (21.4% in resection group versus 15.6 % in RFA group). The mean hospital stay was 7±2.9 in resection group and 1±1.2 in RFA group; with a significant shorter stay (P <0.001) in RFA group. Patients included in RFA group showed significantly increased scores of psychological and physical welfare compared to resection group (P <0.001). Subgroup analysis showed non significant difference between both groups as regards the 2 years overall survival & recurrence-free survival in tumours less than 3cm. On the other hand, surgical resection was superior to RFA for 2 years overall survival & the recurrence-free survival in subgroup analyses for lesions >3cm, <5cm. Conclusions: In patients with Child A cirrhosis with solitary HCC less than 3 cm, RFA provided results with non-significant difference to surgical resection with the advantages of being less invasive, shorter hospital stay, and better quality of life. While in tumours between 3 and 5 cm, surgical resection was superior to RFA having better overall survival and tumor-free recurrence.