2019 ASCO Annual Meeting!
Session: Gastrointestinal (Noncolorectal) Cancer
Type: Oral Abstract Session
Time: Sunday June 2, 9:45 AM to 12:45 PM
Location: Arie Crown Theater
A multicenter randomized controlled trial to evaluate the efficacy of surgery vs. radiofrequency ablation for small hepatocellular carcinoma (SURF trial).
Gastrointestinal (Noncolorectal) Cancer
2019 ASCO Annual Meeting
J Clin Oncol 37, 2019 (suppl; abstr 4002)
Author(s): Namiki Izumi, Kiyoshi Hasegawa, Yujiro Nishioka, Tadatoshi Takayama, Naoki Yamanaka, Masatoshi Kudo, Mitsuo Shimada, Masahumi Inomata, Shuichi Kaneko, Hideo Baba, Kazuhiko Koike, Masao Omata, Masatoshi Makuuchi, Yutaka Matsuyama, Norihiro Kokudo; Musashino Red Cross Hospital, Tokyo, Japan; The University of Tokyo, Tokyo, Japan; Nihon University School of Medicine, Department of Digestive Surgery, Tokyo, Japan; Department of Surgery, Meiwa Hospital, Nishinomiya, Japan; Kindai University, Faculty of Medicine, Osaka, Japan; Tokushima University, Tokushima, Japan; Oita University, Oita, Japan; Kanazawa University Hospital, Kanazawa, Japan; Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; University of Tokyo, Tokyo, Japan; Yamanashi Prefectural Central Hospital, Kofu, Japan; Towa Hospital, Tokyo, Japan; Department of Biostatistics, School of Public Health, University of Tokyo, Tokyo, Japan; National Center for Global Health and Medicine, Tokyo, Japan
Background: Surgery (SUR) and radiofrequency ablation (RFA) are both known to be effective therapy for treating patients with small oligonodular hepatocellular carcinoma (HCC), however there is only insufficient evidence about which therapy is more preferred approach. This randomized controlled trial was designed to prospectively compare the efficacy of SUR and RFA as the first approach to primary HCC. Methods: In this open-label trial undertaken at 49 hospital in Japan, we recruited patients having primary HCC with tumor foci numbering less than 3, each measuring 3 cm or less, Child-Pugh score of 7 or less, ages between 20 and 79 year. Before randomization, technical and liver functional feasibility for both treatment arms were confirmed by joint chart review by surgeons and hepatologists. Patients were then randomly assigned in a 1:1 ratio to undergo SUR or RFA, stratified by age, infection of hepatitis-C virus, number of tumors, tumor size and institution. The primary endpoint was recurrence free survival (RFS) and overall survival (OS). Results: Between April 2009 and August 2015, total 308 patients were enrolled to this trial. Because of ineligibility 15 patients were excluded, therefore 145 patients underwent SUR and 148 patients underwent RFA finally. There was no perioperative mortality. Under the median follow-up of 5 years, the 3-year RFS of patients underwent SUR and RFA was 49.8%, 47.7%, respectively (hazard ration [HR] 0.96, 95% CI 0.72-1.28; p = 0.793). OS will be analyzed and published after two years. Conclusions: SUR and RFA were both safe therapeutic approaches and provided equally RFS for early stage HCC smaller than 3 cm. Clinical trial information: UMIN000001795.