BACKGROUND: Radiofrequency Ablation is the most widely performed percutaneous treatment for Hepatocellular Carcinoma. This multicentre study was aimed at assessing the complication, overall survival and disease-free survival rates in cirrhotic patients with single Hepatocellular Carcinoma nodule ≤3cm undergoing Radiofrequency Ablation. METHODS: Data of 365 patients (59% males; mean age 67±8 years), Child-Pugh A/B, with single Hepatocellular Carcinoma nodule ≤3cm (tumours >2-3cm=127/236), showing complete necrosis after Radiofrequency Ablation between 1998 and 2010 in 7 Italian Centers were retrospectively reviewed. Complication, overall survival and disease-free survival rates were analyzed as main clinical end-points. RESULTS: Major complications were observed in 8 patients (2.2%) and minor complications in 23 patients (6.3%). The 3-, and 5-year overall survival rates were 80% and 64%. One hundred and seven patients (29.5%) died, being 41 deaths (38.3%) Hepatocellular Carcinoma-related. At multivariate analysis only age (p=0.04; OR 2.29), ascites (p<0.001; OR 3.74) and Child-Pugh class ≥B8 (p=0.003; OR 2.42) were confirmed as independent predictors for overall survival. The disease-free survival rates at 3- and 5-year were 50%, and 41.8%. CONCLUSIONS: Radiofrequency Ablation is an effective and safe tool for the treatment of single Hepatocellular Carcinoma ≤3cm providing excellent 5-year overall survival and disease-free survival rates. Patient's age and liver status appeared as main determinants of outcome.
Francica, G., Saviano, A., De Sio, I., De Matthaeis, N., Brunello, F., Cantamessa, A., Giorgio, A., Scognamiglio, U., Fornari, F., Giangregorio, F., Piscaglia, F., Gualandi, S., Caturelli, E., Roselli, P., Rapaccini, G. L., Pompili, M., Long-term effectiveness of Radiofrequency Ablation for solitary small Hepatocellular Carcinoma: A retrospective analysis of 363 patients, <<DIGESTIVE AND LIVER DISEASE>>, 2013; 45 (4): 336-341. [doi:10.1016/j.dld.2012.10.022] [http://hdl.handle.net/10807/39945]
Long-term effectiveness of Radiofrequency Ablation for solitary small Hepatocellular Carcinoma: A retrospective analysis of 363 patients
Saviano, Antonio;De Matthaeis, Nicoletta;Rapaccini, Gian Ludovico;Pompili, Maurizio
2012
Abstract
BACKGROUND: Radiofrequency Ablation is the most widely performed percutaneous treatment for Hepatocellular Carcinoma. This multicentre study was aimed at assessing the complication, overall survival and disease-free survival rates in cirrhotic patients with single Hepatocellular Carcinoma nodule ≤3cm undergoing Radiofrequency Ablation. METHODS: Data of 365 patients (59% males; mean age 67±8 years), Child-Pugh A/B, with single Hepatocellular Carcinoma nodule ≤3cm (tumours >2-3cm=127/236), showing complete necrosis after Radiofrequency Ablation between 1998 and 2010 in 7 Italian Centers were retrospectively reviewed. Complication, overall survival and disease-free survival rates were analyzed as main clinical end-points. RESULTS: Major complications were observed in 8 patients (2.2%) and minor complications in 23 patients (6.3%). The 3-, and 5-year overall survival rates were 80% and 64%. One hundred and seven patients (29.5%) died, being 41 deaths (38.3%) Hepatocellular Carcinoma-related. At multivariate analysis only age (p=0.04; OR 2.29), ascites (p<0.001; OR 3.74) and Child-Pugh class ≥B8 (p=0.003; OR 2.42) were confirmed as independent predictors for overall survival. The disease-free survival rates at 3- and 5-year were 50%, and 41.8%. CONCLUSIONS: Radiofrequency Ablation is an effective and safe tool for the treatment of single Hepatocellular Carcinoma ≤3cm providing excellent 5-year overall survival and disease-free survival rates. Patient's age and liver status appeared as main determinants of outcome.
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