studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 395A
365
When to perform surgical resection or radiofrequency
ablation for early hepatocellular carcinoma? A nomogram-guided
treatment strategy
Po-Hong Liu 1,2 , Chia-Yang Hsu 2,3 , Yi-Hsiang Huang 1,4 , Chien-
Wei Su 1,2 , Han-Chieh Lin 1,2 , Teh-Ia Huo 1,5 ; 1 Department of Medicine,
Taipei Veterans General Hospital, Taipei, Taiwan; 2 Faculty
of Medicine, National Yang-Ming University, Taipei, Taiwan;
3 Department of Internal Medicine, University of Nevada School
of Medicine, Reno, NV; 4 Institute of Clinical Medicine, National
Yang-Ming University, Taipei, Taiwan; 5 institute of Pharmacology,
National Yang-Ming University, Taipei, Taiwan
Background&Aims: Radiofrequency ablation (RFA) is indicated
for early hepatocellular carcinoma (HCC). The comparative
efficacy between RFA and surgical resection (SR) is inconclusive.
We aimd to develop a prognostic nomogram for recurrence-free
survival (RFS) after RFA and to evaluate its ability
in improving treatment algorithm. Methods: We enrolled 836
patients with BCLC very early/early HCC receiving SR or RFA.
Nomogram was constructed with Cox proportional hazards
model. RFA patients were stratified into low-risk and high-risk
groups. The RFS and overall survival (OS) of two risk groups
were compared with SR patients by propensity score matching
analysis. Results: A prognostic nomogram was built based
on number and size of tumor, platelet count, albumin level,
and model for end-stage liver disease score with a c-index of
0.69. SR provided better RFS and OS compared with high-risk
(nomogram score ≥9.8) RFA patients in the propensity model.
The 5-year RFS rates were 36% vs. 11%, while 5-year OS rates
were 74% vs. 60% for SR and high-risk RFA group, respectively
(both p