TY - JOUR
T1 - Laparoscopic surgery versus radiofrequency ablation for the treatment of single hepatocellular carcinoma ≤3 cm in the elderly
T2 - a propensity score matching analysis
AU - Conticchio, Maria
AU - Delvecchio, Antonella
AU - Ratti, Francesca
AU - Gelli, Maximiliano
AU - Anelli, Ferdinando M.
AU - Laurent, Alexis
AU - Vitali, Giulio C.
AU - Magistri, Paolo
AU - Assirati, Giacomo
AU - Felli, Emanuele
AU - Wakabayashi, Taiga
AU - Pessaux, Patrick
AU - Piardi, Tullio
AU - Di Benedetto, Fabrizio
AU - de'Angelis, Nicola
AU - Javier Briceno, Delgado F.
AU - Rampoldi, Antonio G.
AU - Adam, René
AU - Cherqui, Daniel
AU - Aldrighetti, Luca
AU - Memeo, Riccardo
N1 - Publisher Copyright:
© 2021
PY - 2022/1/1
Y1 - 2022/1/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85108528285&partnerID=8YFLogxK
U2 - 10.1016/j.hpb.2021.05.008
DO - 10.1016/j.hpb.2021.05.008
M3 - Article
C2 - 34167892
AN - SCOPUS:85108528285
SN - 1365-182X
VL - 24
SP - 79
EP - 86
JO - HPB
JF - HPB
IS - 1
ER -