Radiofrequency ablation for hepatocellular carcinoma: 10-year outcome and prognostic factors.

Shiina S, Tateishi R, Arano T, Uchino K, Enooku K, Nakagawa H, Asaoka Y, Sato T, Masuzaki R, Kondo Y, Goto T, Yoshida H, Omata M, Koike K
Am J Gastroenterol. 2012 107 (4): 569-77; quiz 578

PMID: 22158026 · PMCID: PMC3321437 · DOI:10.1038/ajg.2011.425

OBJECTIVES - Radiofrequency ablation (RFA) is widely performed for hepatocellular carcinoma (HCC). However, there has been no report on 10-year outcome of RFA. The objective of this study was to report a 10-year consecutive case series at a tertiary referral center.

METHODS - We performed 2,982 RFA treatments on 1,170 primary HCC patients and analyzed a collected database.

RESULTS - Final computed tomography images showed complete tumor ablation in 2,964 (99.4%) of 2,982 treatments performed for the 1,170 primary HCC patients. With a median follow-up of 38.2 months, 5- and 10-year survival rates were 60.2% (95% confidence interval (CI): 56.7-63.9%) and 27.3% (95% CI: 21.5-34.7%), respectively. Multivariate analysis demonstrated that age, antibody to hepatitis C virus (anti-HCV), Child-Pugh class, tumor size, tumor number, serum des-γ-carboxy-prothrombin (DCP) level, and serum lectin-reactive α-fetoprotein level (AFP-L3) were significantly related to survival. Five- and 10-year local tumor progression rates were both 3.2% (95% CI: 2.1-4.3%). Serum DCP level alone was significantly related to local tumor progression. Five- and 10-year distant recurrence rates were 74.8% (95% CI: 71.8-77.8%) and 80.8% (95% CI: 77.4-84.3%), respectively. Anti-HCV, Child-Pugh class, platelet count, tumor size, tumor number, serum AFP level, and serum DCP level were significantly related to distant recurrence. There were 67 complications (2.2%) and 1 death (0.03%).

CONCLUSIONS - RFA could be locally curative for HCC, resulting in survival for as long as 10 years, and was a safe procedure. RFA might be a first-line treatment for selected patients with early-stage HCC.

MeSH Terms (25)

Aged alpha-Fetoproteins Biomarkers Biomarkers, Tumor Carcinoma, Hepatocellular Catheter Ablation Disease Progression Female Follow-Up Studies Humans Lectins Liver Neoplasms Male Multivariate Analysis Neoplasm Recurrence, Local Neoplasm Staging Prognosis Prospective Studies Protein Precursors Prothrombin Reoperation Risk Factors Survival Rate Tomography, X-Ray Computed Treatment Outcome

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