• Min-Shan Chen, Jin-Qing Li, Yun Zheng, Rong-Ping Guo, Hui-Hong Liang, Ya-Qi Zhang, Xiao-Jun Lin, and Wan Y Lau.
• Department of Hepatobiliary Surgery, Cancer Centre of Sun Yat-Sen University, Guangzhou, China. Cms64@21cn.com
• Ann. Surg. 2006 Mar 1; 243 (3): 321328321-8.

ObjectiveTo compare the results of percutaneous local ablative therapy (PLAT) with surgical resection in the treatment of solitary and small hepatocellular carcinoma (HCC).Summary Background DataPLAT is effective in small HCC. Whether it is as effective as surgical resection in the long-term survivals remains unknown.MethodsWe conducted a prospective randomized trial on 180 patients with a solitary HCC ResultsOf the 90 patients who were randomized to PLAT, only 71 received PLAT because 19 withdrew their consent. Of the 90 patients who were randomized to surgical resection, a single Couinaud liver segment resection was carried out in 69 patients, 2 segments in 16 patients, and 3 or more segments in 3 patients. Ethanol injection was given during open surgery in 2 patients. Only 1 patient died after surgical resection within the same hospital admission. Posttreatment complications were more often and severe after surgery than PLAT. The 1-, 2-, 3-, and 4-year overall survival rates after PLAT and surgery were 95.8%, 82.1%, 71.4%, 67.9% and 93.3%, 82.3%, 73.4%, 64.0%, respectively. The corresponding disease-free survival rates were 85.9%, 69.3%, 64.1%, 46.4% and 86.6%, 76.8%, 69%, 51.6%, respectively. Statistically, there was no difference between these 2 treatments.ConclusionPLAT was as effective as surgical resection in the treatment of solitary and small HCC. PLAT had the advantage over surgical resection in being less invasive.

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