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Comparison of Survival Outcomes in Transarterial Ethanol Ablation and Liver Resection for Solitary Hepatocellular Carcinoma ≤ 5 cm in Patients Stratified by Liver Function

  • Clinical Investigation
  • INTERVENTIONAL ONCOLOGY
  • Published:
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Abstract

Purpose

To compare the survival outcomes of patients treated with transarterial ethanol ablation (TEA) with those treated with liver resection (LR) for solitary HCC less than 5 cm in diameter, in patients stratified according to liver function using ALBI grade.

Materials and Methods

This retrospective study approved by the Institutional Committee included all treatment-naïve patients with solitary HCC (≤ 5 cm) and Child–Pugh score 5, and who had received TEA (33 patients) or LR (192 patients) between 2004 and 2012. Treatment outcomes were compared between patients treated with TEA and LR after a period of at least 7 years of follow-up. Comparison was repeated for those patients with ALBI grade 2 or 3.

Results

Both overall survival (OS, months) and recurrence-free survival (RFS months) were significantly longer in the LR group (OS: LR 129.7[119.5, 140], TEA 69.1[55.9, 82.3], P < 0.0001; RFS: LR 91.3[43.5, 139.1], TEA 13.8 [11, 16.5], P < 0.0001). In patients with ALBI grade 2 or 3, there was no significant difference between the groups in OS or RFS (OS: LR 43.1[0, 91.2], TEA 55.4 [43.7, 67.2], P = 0.65; RFS: LR 17.8 [11.4, 24.2], TEA 11.9 [6.7, 17.1], P = 0.132). Transient epigastric discomfort and low-grade fever without consequence occurred in 8 patients (8/33 or 24.2%) in the TEA group.

Conclusion

The overall survival after LR for HCCs ≤ 5 cm was superior to that after TEA but similar when compared in patients with ALBI grade 2 or 3, the ALBI grade is useful for patient selection for TEA or LR for HCCs ≤ 5 cm.

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Acknowledgement

The authors would like to thank Miss. Tiffany Lau and Mr. Lee Kwok Tung for their help in this study.

Funding

This study was funded by the Vascular and Interventional Radiology Foundation. The funding body had not involved in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.

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Authors and Affiliations

  1. Department of Imaging and Interventional Radiology, Main Clinical Block and Trauma Centre, The Chinese University of Hong Kong, Prince of Wales Hospital, c/o Rm 2A061, 2/F, Main Clinical Block and Trauma Centre, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong SAR

    Simon Chun Ho Yu, Joyce Wai Yi Hui & Carmen Chi Min Cho

  2. Vascular and Interventional Radiology Foundation Clinical Science Center, Shatin, Hong Kong SAR

    Simon Chun Ho Yu, Joyce Wai Yi Hui & Carmen Chi Min Cho

  3. Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR

    Charing Ching Ning Chong, Sunny Cheung, John Wong & Kit Fai Lee

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  1. Simon Chun Ho Yu
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Correspondence to Simon Chun Ho Yu.

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Yu, S.C.H., Hui, J.W.Y., Chong, C.C.N. et al. Comparison of Survival Outcomes in Transarterial Ethanol Ablation and Liver Resection for Solitary Hepatocellular Carcinoma ≤ 5 cm in Patients Stratified by Liver Function. Cardiovasc Intervent Radiol 45, 315–327 (2022). https://doi.org/10.1007/s00270-021-02768-7

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