TDNet Discover

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer death worldwide. This multifactorial disease has no universally accepted system of staging and grading, or guideline for management. Purpose: The aim of this research was to identify the presentations of HCC that show improved or comparable survival rates and complications when treated with Radiofrequency ablation (RFA) compared to surgical resection (SR). Methods: An evidence-based clinical review (EBCR) was conducted by three independent researchers searching for articles using Medline, PubMed, and Google Scholar between December 2021 and February 2022. Three articles were reviewed, individually assessed by each researcher using a quality assessment tool, and approved by a 2-member research panel. After approval, data extraction, independent review, and qualitative assessments were performed on the three articles. Results: Three studies totaling 28,982 HCC patients were included in this EBCR. Overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) for the RFA group was found to be significantly shorter than SR at longer time intervals or with larger tumor sizes. No significant difference was found between RFA and SR regarding OS and DFS/RFS. The RFA group did not show improved OS or DFS/RFS rates but experienced significantly lower complication rates and postoperative complications compared to the SR group. Conclusion: There was no instance of RFA being superior to SR regarding OS, DFS, and RFS and any time interval. RFA survival outcomes are only comparable to SR survival outcomes in the best of cases. RFA demonstrated favorable complications and complication rates compared to SR regardless of tumor size. Further investigation directly comparing RFA and SR as treatments of patients with HCC is necessary to provide a conclusion;though using patients treated with RFA who would otherwise be better suited for SR may be unethical and such an investigation would be unacceptable.