Longitudinal comparisons of results in surgical resection and percutaneous ethanol injection therapy (PEI): Change in treatment strategy for @entity157 ( XXXX ).

@entity1 @entity82 @entity5 @entity648 @entity157
UNASSIGNED: 4135 Background: Both surgical resection and local ablation therapy such as PEI have been widely used for @entity1 (pts) with small @entity157 . Each treatment is selected mainly according to the technical feasibility of treatment because retrospective data suggest that the two treatments are comparable in terms of survival. To assess longitudinal changes in treatment strategy for small @entity157 , two retrospective comparative studies were conducted in the 4 major center hospitals where pretreatment conferences are well organized by surgeons and nonsurgical specialists for PEI. METHODS: Clinical information on the @entity1 characteristics was compared between @entity1 with newly diagnosed small @entity157 (smaller than 3 cm and 3 or less in number) in 1990-1994 and 1998-1999 who underwent surgery or PEI before introduction of radiofrequency ablation therapy in each hospital. Long-term results with reference to their survival significance were also analyzed. RESULTS: Of the 97 pts in 1990-1994, 58 (60%) underwent surgery and 39 (40%) were treated with PEI. In the 151 pts in 1998-1999, 95 (63%) were surgically treated and 56 (37%) received PEI. No significant differences in @entity1 characteristics between the 1990-1994 pts and the 1998-1999 pts were observed except for a better @entity648 level in the 1998-1999 pts. In the surgical pts, the 1998-1999 pts included more pts with solitary @entity5 and showed better hepatic reserve according to the ICG test, and better albumin and @entity648 levels compared to the 1990-1994 pts. In the PEI pts, the 1998-1999 pts were older and included more pts with @entity82 than the 1990-1994 pts. Although the overall survival rates were identical between the 1990-1994 pts and the 1998-1999 pts, the 1998-1999 surgical pts survived significantly longer (p=0.03), and the PEI pts tended to survive shorter (p=0.09) compared to the 1990-1994 pts. CONCLUSIONS: This study suggests that either surgery or PEI is being selected according to risk of surgical morbidity is being promoted, resulting in longitudinal changes in outcome of pts treated with each approach. No significant financial relationships to disclose.
