Aim: There is no definite view on initial treatment selection for hepatocellular carcinoma (HCC) less than 3 cm. In our institute, treatment results of local ablation therapy and clinicopathological examination of small HCC, “Less than 3 cm in diameter with simple nodule type or small nodular with indistinct margin in gloss type” was established as the therapeutic indication criteria of percutaneous radiofrequency ablation therapy (RFA). We have introduced it as a part of treatment strategy. This time, we compare the treatment results of RFA and hepatectomy after that and examined whether the therapeutic indication criteria of RFA in our institute was reasonable or not.
Method: The disease-free survival rate and survival rate of 81 patients in the percutaneous RFA and 180 cases in the hepatectomy were examined in 261 cases of initial solitary HCC, less than 3 cm in diameter from 1999 to 2008. RFA was performed under general anesthesia in 80 cases and Cool-tip was used in 66 cases.
Results: Significant difference was not found between gender, age, hepatitis virus, alcohol history, Child-Pugh, tumor diameter, platelets, AFP and PIVKA, but only the ICGR15 showed a significant difference between the RFA group: 28.2% and the hepatectomy group: 16.8%, respectively. The 5-year disease-free survival rate was 38.3% for the RFA group and 36.3 for the hepatectomy group. The 5-year survival rate was 71.8% in the RFA group and 81.3% in the hepatectomy group. No statistically significant difference was observed between the two groups.
Conclusion: The outcome of "Less than 3 cm in diameter with simple nodule type or small nodular with indistinct margin in gloss type" treatment in RFA was equivalent to that in the hepatectomy, and the treatment indication criteria established in our institute was reasonable.