Open radiofrequency ablation, splenectomy, and pericardial devascularization for small hepatocellular carcinomas with portal hypertension and hypersplenism represent an alternative therapeutic option for carefully selected patients in the absence of a liver donor, according to results published in Journal of Investigative Surgery. Researchers examined short- and long-term outcomes with open radiofrequency ablation plus splenectomy and pericardial devascularization compared with liver transplantation for patients with HCC with portal hypertension and hypersplenism. The study and control groups each included 32 patients who were matched by tumor size, age, sex, tumor site, and Child-Pugh staging. Over a mean follow-up period of 43.2 months for the study group and 44.9 months for the control group, investigators observed no significant differences in cumulative overall survival or the incidence of portal vein thrombosis between the two groups. Disease-free survival was better in the control group versus the study group (P<0.001). However, the study group experienced significantly less intraoperative blood loss as well as lower rates of postoperative pleural effusion and pneumonia (all P<0.05).
