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CardioVascular and Interventional Radiology

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01-06-2014 | Clinical Investigation

Radiofrequency Ablation for Intrahepatic Recurrent Hepatocellular Carcinoma: Long-Term Results and Prognostic Factors in 168 Patients with Cirrhosis

Authors: Dong Ho Lee, Jeong Min Lee, Jae Young Lee, Se Hyung Kim, Joon Koo Han, Byung Ihn Choi

Published in: CardioVascular and Interventional Radiology | Issue 3/2014

Abstract

Purpose

To analyze the clinical outcome of radiofrequency ablation (RFA) for recurrent intrahepatic hepatocellular carcinoma (HCC) after variable first-line treatment.

Materials and Methods

From January 2006 to December 2007, 168 consecutive patients (133 male, 35 female; mean age 66.7 ± 10.1 years) with cirrhosis (Child–Pugh class A/B [146/22]) who underwent RFA for treatment for recurrent intrahepatic HCC ≤5 cm, and in up to three nodules (214 HCCs; mean diameter 20.8 ± 7.5 mm; 38 multinodular forms), were included. Univariate and multivariate analyses for potential clinical, tumor-related, and radiologic factors affecting overall and recurrence-free patient survival were performed using the Cox proportional hazard model.

Results

Major complications occurred in 5 patients (5 of 168, 3.0 %), although there were no procedure-related deaths. Complete ablation was achieved in 161 patients (161 of 168, 95.8 %). After a mean follow-up period of 4 ± 21 months, local tumor progression, distant intrahepatic recurrence, and extrahepatic metastasis occurred in 22, 132, and 41 patients, respectively. Overall 5-year survival and recurrence-free survival were 48.0 and 11.9 %, respectively. Significant predicting factors for overall patient survival were Child–Pugh class B (relative risk [RR] = 4.52, 95 % confidence interval [CI] 1.97–10.34; P < 0.001), serum alpha-fetoprotein (AFP) level (RR = 1.01, 95 % CI 1.01–1.01; P < 0.001), number of HCC nodules (RR = 1.70, 95 % CI 1.04–2.76; P = 0.033), tumor size (RR = 1.40, 95 % CI 1.07–1.83; P = 0.014), and presence of portosystemic collaterals (RR = 1.78, 95 % CI 1.09–2.92; P = 0.022).

Conclusion

RFA is a safe and effective treatment modality for recurrent intrahepatic HCC and has a 5-year survival rate of 48.0 %. Serum AFP level, Child–Pugh class, tumor number and size, and presence of portosystemic collaterals significantly affect overall patient survival.

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Title: Radiofrequency Ablation for Intrahepatic Recurrent Hepatocellular Carcinoma: Long-Term Results and Prognostic Factors in 168 Patients with Cirrhosis
Authors: Dong Ho Lee
Jeong Min Lee
Jae Young Lee
Se Hyung Kim
Joon Koo Han
Byung Ihn Choi
Publication date: 01-06-2014
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 3/2014
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-013-0708-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Radiofrequency Ablation for Intrahepatic Recurrent Hepatocellular Carcinoma: Long-Term Results and Prognostic Factors in 168 Patients with Cirrhosis

Abstract

Purpose

Materials and Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusion

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