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.

Laparoscopic surgery versus radiofrequency ablation for the treatment of single hepatocellular carcinoma ≤3 cm in the elderly: a propensity score matching analysis / 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.; Memeo, R.. - In: HPB. - ISSN 1365-182X. - 24:1(2021), pp. 79-86. [10.1016/j.hpb.2021.05.008]

Laparoscopic surgery versus radiofrequency ablation for the treatment of single hepatocellular carcinoma ≤3 cm in the elderly: a propensity score matching analysis

Magistri P.;Assirati G.;Di Benedetto F.;
2021

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.
2021
HPB
24
1
79
86
Laparoscopic surgery versus radiofrequency ablation for the treatment of single hepatocellular carcinoma ≤3 cm in the elderly: a propensity score matching analysis / 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.; Memeo, R.. - In: HPB. - ISSN 1365-182X. - 24:1(2021), pp. 79-86. [10.1016/j.hpb.2021.05.008]
Conticchio, M.; Delvecchio, A.; Ratti, F.; Gelli, M.; Anelli, F. M.; Laurent, A.; Vitali, G. C.; Magistri, P.; Assirati, G.; Felli, E.; Wakabayashi, T...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1249420
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