Page 215 - ebook HCC

GENEVA, SWITZERLANDA, SWITZERLAND
PROGRAMME AND ABSTRACTSAND ABSTRACTS
EASL HCC SUMMITHCC SUMMIT
212 PROGRAMME GENEV EASL 213
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212
FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
FEBRUAR
Poster Board Number C11
LAPAROSCOPIC RADIOFREQUENCY ABLATION
VERSUS HEPATIC RESECTION IN THE
TREATMENT OF VERY EARLY HEPATOCELLULAR
CARCINOMA IN CIRRHOTIC CARCINOMA: A
COHORT STUDY

Roberto Santambrogio , Mara Costa , Savino Bruno , Michael D. Kluger , Methodology: Two independent cohort series (Milan, Creteil), which include 855
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Juan Salceda , Andrea Belli , Alexis Laurent , Matteo Barabino , patients with HCC who underwent HR (n=529) or LRFA (n=326), were retrospectively
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Enrico Opocher , Daniel Azoulay , Daniel Cherqui 6 4 analysed. 176 patients had a VE HCC. Patients not suitable to HR (requiring a very large
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1 Chirurgia 2 – Epato-bilio-pancreatica e Digestiva , A.O. San Paolo – Università degli parenchymal loss at HR, due to the position of the lesion) were treated by LRFA (n=92),
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Studi, Milano, Italy, Service de Chirurgie Digestive, Hepato-bilio-pancreatique et the others underwent HR (n=84). At the time of surgical procedure no relevant differences
Transplantation Hepatique, Hôpital Henri Mondor, Créteil, France, Medicina Interna ed were seen between the 2 groups in term of liver disease status. In any case, Kaplan-Meier
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Epatologia, A.O. Fatebenefratelli ed Oftalmico, Milano, Italy, Section of Hepatobiliary method was used to assess overall survival (OS), tumour recurrence rate and disease-
Surgery and Liver Transplantation, Department of Surgery, New York Presbyterian free survival (DFS) before and after propensity score matching
Hospital – Weill-Cornell Medical Center, New York, United States, Dipartimento di
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Chirurgia Oncologica Addominale, Istituto Nazionale Tumori “G. Pascale” , Napoli, Italy, Results: The 1-, 3- and 5-year OS rates for the LRFA group and the HR group were 92%,
6 Centre Hépato-Biliaire, Hôpital Paul Brousse, Villejuif, France 66%, 46% and 94%, 89%, 75% respectively. The corresponding DFS rates for the 2 groups
were 64%, 30%, 14%, and 82%, 58%, 39%, respectively. OS and DFS were significantly
Corresponding author’s e-mail: mara.costa@unimi.it lower in the RFA group than in the HR group (p=0.0029 and p=0.0002, respectively).
The 5-year HCC recurrence rate was higher in the LRFA group than in the HR group
(82% vs. 56%; p=0.0008). After propensity score matching, only survival rates become not
Introduction: Available studies have shown conflicting results concerning survival rates significantly different. Multivariate analysis confirmed that treatment and BCLC stage are
for patients with cirrhosis and concurrent very early (VE) hepatocellular carcinoma (HCC) the only predictive factors for survival and intra-hepatic recurrences
(stage 0 according BCLC classification: single <2 cm or carcinoma in situ, Child A) treated
by laparoscopic radiofrequency ablation (LRFA) or hepatic resection (HR). Even if very Conclusions: HR yielded better disease-free survival rates than LRFA with not significant
CLINICAL POSTER ABSTRACTS of patients: RFA should be the first-line therapy and HR should be considered only in which RFA may be less effective, if not dangerous. HR is the first-line option treatment for CLINICAL POSTER ABSTRACTS
difference in survival. HR should be preferred in patients with peripheral tumours or
few comparative studies between HR and RFA have been reported for VE-HCC, some
with tumours located near gallbladder, main biliary ducts, bowel loops or big vessels, in
experts have recommended modification of BCLC therapeutic algorithm in this subgroup
patients with failure of or contraindications to RFA
patients with VE-HCC
Aims: To compare HR versus LRFA as initial treatment for VE-HCC on survival, disease

free survival (DFS) and HCC recurrences in a large cohort of patients followed in clinical
practice.