To explore the clinical effect of different liver transection methods in hepatectomy for multifocal primary liver cancer, and analyze the advantages of radiofrequency ablation (RFA) assisted liver transection in hepatectomy.

The clinical data of 156 patients with multifocal primary liver cancer diagnosed in Lu’ an Hospital Affiliated to Anhui Medical University from January 2014 to December 2019 were analyzed retrospectively. Among them, 72 cases were treated with RFA assisted liver transection during hepatectomy (RFA group), and 84 cases only underwent hepatectomy as the control group. The operation time, hilar blocking time, intraoperative bleeding and postoperative hospital stay were observed. The levels of liver function indexes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alpha-fetoprotein (AFP), total cholic acid (TBA) and total bilirubin (TBIL) before and after operation, as well as postoperative complications and postoperative survival were compared between the two groups.

Compared with the control group, the operation time, hilar blocking time, postoperative hospital stay and intraoperative bleeding in RFA group were significantly shorter or less (all P<0.05). There were no significant differences in the levels of ALT, AST, AFP, TBA and TBIL between the two groups before operation, and the corresponding liver function indexes of all patients were significantly decreased on the 7th day after surgery (P<0.05). In addition, the levels of ALT, AST and AFP in the RFA group after surgery were significantly different from those in the control group (P<0.05). The incidence of complications in RFA group was 5.56% (4/72), which was lower than 15.48% in the control group (χ²=3.930, P=0.047). The cumulative overall survival rate and disease-free survival rate at 1-, 3- and 5-year were 92.85%, 64.28%, 57.14% and 88.10%, 58.33% and 47.62% in the control group; 100.0%, 87.50%, 69.44%, and 95.83%, 75.00%, and 61.11% in RFA group, respectively. There were significant differences between the two groups in the 3-, 5-year cumulative overall survival rate and 1-, 3-, 5-year cumulative disease-free survival rate (P<0.05).

RFA assisted liver transection in hepatectomy has the advantages of less bleeding, lower incidence of postoperative complications and higher long-term survival rate for the treatment of paitents with multifocal primary liver cancer. It can be used in the combination with hepatectomy in clinical application and has high promotion value.