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Objective:To compare the clinical effect of radiofrequency ablation and surgical resection for small primary liver carcinoma.Methods:84 patients with small primary liver carcinoma whose tumor diameter≤5cm were recruited during Feb.2004 to May.2010 in the Affiliated Tumor Hospital of Guangxi Medical University, in which 40 cases were treated by radiofrequency ablation and other 44 cases were after surgery. Multivariate statistics was performed to analyze clinical data and follow-up results in order to provide useful references for the treatment of small primary liver carcinoma in clinical practice.Results:1. The results of radiofrequency ablation group were as follows:complete clearance ratio was 87.50%, the incidence of complications was 10.00%, recurernce and metastasis rate was 75.00%. The results for operation group were as follows:complete clearance ratio was 100%, the incidence of complications was 15.91%, recurernce and metastasis rate was 63.64%.There was great statistical significance (p=0.02)between the two groups in the complete clearance ratio of tumor, in contrast there was no statistical significance in terms of complication rate, recurernce and metastasis rate as well as disease free survival.2. Radio frequency ablation group and operation group:1,3,5- disease free survival were 85.00%,37.50%,25.06%and88.59%,50.0%,31.78% respectively. Mean survival time was 30.08 months and 32.76 months, which shows no cumulative survival differences between the two groups.Two sub-groups were divided according to the tumor diameter:one was≤3cm group,1,3,5- disease free survival for radioreequency ablation group and operation were 85.72%,47.58%,33.33%and87.46%,62.50%,43.78%, Mean survival time was 39.43 months and 38.97 months. there was no cumulative survival differences between the two groups.3cm<The other group≥5cm,1,3,5-disease free survival for radiofrequency ablation group and operation group were 84.25%,26.36%,15.82% and 87.32%,42.88%,25.00%. Mean survival time between radiofrequency ablation group was 26.97 months and operation group was 31.25 months,. there was no cumulative survival differences between the two groups. The data shows no statistical significance in aspect of free survival by Cox regression analysis between two groups.3 radioreequency ablation group and Operation group:1,3,5-cumulative survival rate were 100%,66.34%,37.42%and 100%,63.71%,50.43%, the average survival time were 47.62 months and 50.78 months. There was no statistical significance in aspect of cumulative survival rate.≤3cm group:1,3,5-cumulative survival rate for group radiofrequency ablation and operation group were 100%,78.83%,51.75%andl00%,78.14%, 56.12%, the average survival time were 52.98 and 52.28 months, there was no statistical significance in aspect of cumulative survival rate.3cm < The other group≥5cm:1,3,5-cumulative survival rate for radioreequency ablation group and operation group were 100%,56.44%, 21.24%and 100%,52.82%,44.27%. the average survival time were 40.07 and 47.88 months. There was no statistical significance in aspect of cumulative survival rate. Multivariate statistical analysis indicated only the number of tumor was statistically significant for overall survival, there was no statistical significance in terms of overall survival when avoiding some factors.Conclusion:Radiofrequency ablation has the advantage of safety and minimally invasiveness, complications are relatively light compared with the surgical resection, in addition, it is effective and has good repeatability; radiofrequency ablation and surgical resection are similar in the treatment of small hepatocellular carcinoma, multiple long-term survival of cancer patients were lower than those of single tumor; as for Patients with small hepatocellular carcinoma, radiofrequency ablation has similar effects as surgical resection and can be used as one of the first choice of treatments.
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