Introduction : Hepatocellular carcinoma (HCC) can be treated with laparoscopic radiofrequency ablation (LRFA), which is generally more accurate and accessible procedure than percutaneous radiofrequency ablation (PRFA). And the oncologic outcome of LRFA is comparable to the other modalities of treatment for HCC, like as PRFA and TACE. However, there was no study to compare the benefits of LRFA over laparoscopic wedge resection of the liver (LWR) in HCC patients with advanced cirrhosis [CTP score - B]. This study aimed to compare the efficacy of LRFA and LWR for HCC treatment.

Methods : Patients who underwent LRFA or LWR as an initial treatment modality between April 2005 and April 2017 were enrolled in the study. The overall and recurrence-free survival rates were examined for each patient. Additionally, propensity score matching was performed for the two groups.

Results : The baseline characteristics of patients in the LRFA and LWR groups showed several minor differences. Multivariate analysis showed that the RFA method was not a critical determinant of recurrence-free or overall survival (p=0.069 and p=0.406). Among patients who underwent LRFA as the initial treatment modality, there was no significant effect of the RFA method on survival. Multivariate analysis showed that LRFA could be one of the strongest factors contributing to improving overall survival in HCC patients (hazard ratio: 0.108, p=0.040). Furthermore, our data were shown that LRFA limited multiple intrahepatic recurrences and prevented a marginal recurrence.

Conclusions : LRFA appears to be superior to LWR and can help reduce morbidity and mortality in HCC patients. Also, LRFA is a feasible treatment