05). The Figures 1 and 2 compared the changes of CT image and MRI image of small HCC before and 1 month buy PD-0332991 after RFA, respectively. As Table 3 showed, eight patients had intrahepatic recurrence local to the RFA area in RFA group, compared with one patient who had new tumors local to the hepatectomy area in hepatectomy group. In addition, another

six patients had new hepatic tumors distant from the ablation site at 3 months post-RFA CT scan in the RFA group. Whereas 10 patients had new hepatic tumors distant to the hepatectomy area at 3 months post-surgery CT scan in the surgical hepatectomy group (P = 0.502). Retreatment was performed in these 11 patients, as shown as Figure 3, including RFA in six patients and chemoembolization in four patients. And two patients among these 11 patients underwent transplantation further after re-recurrence in the Center of Hematology Transplantation,

the First Affiliated Hospital, School of Medicine, Zhejiang University. Other 14 patients gave up further treatment because of failure of liver function, multiple intrahepatic recurrences more than three tumors because of microvascular invasion, side-effects, and other reasons. After a mean follow-up of 40 months, 22 patients (36.6%) in the percutaneous RFA group and 21 patients (35.0%) in the hepatectomy group developed recurrence. There was a trend toward a higher incidence of intrahepatic recurrence (23.3% vs 18.4%) with percutaneous selleck kinase inhibitor RFA group and distant metastases (13.3% vs 16.6%) with surgical hepatectomy group, but the difference was not significant (P > 0.05). Univariate analysis revealed that Child–Pugh classification of the liver functions (P = 0.003), serum AFP level (P = 0.006), HBV infection (P = 0.018), and number of hepatic tumors (P = 0.038) were risk medchemexpress factors for local recurrence. The rates of disease-free survival in the RFA group versus the surgical hepatectomy group at 1, 2, and 3 years were 91.6% versus 90.4%, 87.4% versus 85.2%, and 55.4% versus 41.3% (Fig. 4a). There was no significant difference in the rates of disease-free survival between the two groups (P = 0.443, log–rank test). The overall survival rates at 1, 2, and 3 years

in the percutaneous group were 97.5%, 91.2%, and 82.5%, respectively; and in the surgical hepatectomy group were 93.7%, 86.2%, and 77.5%, respectively. Thus, there was no significant difference in the overall survival rates between the two groups (P = 0.207, log–rank test, Fig. 4b). Our study suggested that percutaneous RFA and hepatectomy provided similar local control and overall disease-free survival for patients with small HCC (tumor size ≤ 3 cm). However, in comparison with hepatectomy, percutaneous RFA showed a lower complication rate and shorter hospital stays. Partial hepatectomy, including liver transplantation, remains the most efficient and treatment “gold standard” for resectable HCC patients with an aim of providing a “cure.