LAUSR

Background: Laparoscopic radiofrequency ablation (LRFA) is used to treat hepatocellular carcinomas (HCCs) that are relatively inaccessible otherwise, and is more accurate than percutaneous RFA (PRFA). However, only a few studies have compared survival outcomes between LRFA and PRFA in patients with HCC. Aims: This study aimed to compare the efficacy of LRFA and PRFA for HCC treatment. Methods: Patients who underwent PRFA or LRFA as an initial treatment modality between April 2005 and April 2016 were enrolled in the study. The overall and recurrence-free survival rates were examined for each patient. Additionally, propensity score matching was performed for the 2 groups. Results: The baseline characteristics of patients in the PRFA and LRFA groups showed several minor differences. Multivariate analysis showed that the RFA method was not a critical determinant of recurrence-free or overall survival (p=0.069 and p=0.406). Among patients who underwent RFA as the initial treatment modality, there was no significant effect of the RFA method on survival. After propensity-score matching, univariate analysis showed a significant difference in overall survival between PRFA and LRFA (p=0.031). Multivariate analysis showed that LRFA could be one of the strongest factors contributed to improve overall survival in HCC patients (hazard ratio: 0.108, p=0.040). Furthermore, our data were shown that LRFA limited multiple intrahepatic recurrences and prevented marginal recurrence. Conclusions: LRFA appears to be superior to PRFA, and can help reduce mortality in HCC patients.