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Hepatic Resection Versus Radiofrequency Ablation for Very Early Stage Hepatocellular Carcinoma: A Markov Model Analysis

Cited 188 time in Web of Science Cited 185 time in Scopus
Authors

Cho, Yun Ku; Kim, Jae Kyun; Kim, Wan Tae; Chung, Jin Wook

Issue Date
2010-04
Publisher
JOHN WILEY & SONS INC
Citation
HEPATOLOGY; Vol.51 4; 1284-1290
Abstract
No adequate randomized trials have been reported for a comparison between hepatic resection (HR) versus radiofrequency ablation (RFA) for the treatment of patients with very early stage hepatocellular carcinoma (HCC), defined as an asymptomatic solitary HCC <2 cm. For compensated cirrhotic patients with very early stage HCC, a Markov model was created to simulate a randomized trial between HR (group I) versus primary percutaneous RFA followed by HR for cases of initial local failure (group II) versus percutaneous RFA monodierapy (group III); each arm was allocated with a hypothetical cohort of 10,000 patients. The primary endpoint was overall survival. The estimates of the variables were extracted from published articles after a systematic review. In the parameter estimations, we assumed the best scenario for HR and the worst scenario for RFA. The mean expected survival was 7.577 years, 7.564 years, and 7.356 years for group I, group II, and group III, respectively. One-way sensitivity analysis demonstrated that group II was the preferred strategy if the perioperative mortality rate was greater than 1.0%, if the probability of local recurrence following an initial complete ablation was <1.9% or if the positive microscopic resection margin rate was >0.3%. The 95% confidence intervals for the difference in overall survival were -0.18-0.18 years between group I and II, 0.06-0.36 years between group I and III, and 0.13-0.30 years between group II and III, respectively. Conclusion: Primary percutaneous RFA followed by HR for cases of initial local failure was nearly identical to HR for the overall survival of compensated cirrhotic patients with very early stage HCC. (HEPATOLOGY 2010; 51:1284-1290.)
ISSN
0270-9139
Language
English
URI
https://hdl.handle.net/10371/78397
DOI
https://doi.org/10.1002/hep.23466
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College of Medicine/School of Medicine (의과대학/대학원)Radiology (영상의학전공)Journal Papers (저널논문_영상의학전공)
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