Radiofrequency ablation of hepatocellular carcinoma: Long-term results and prognostic factors in 235 Western patients with cirrhosis #

作者：G. Nkontchou, A. Mahamoudi, Mounir Aout, Nathalie Ganne‐Carrié, Véronique Grando, Emmanuelle Coderc, Éric Vicaut, Jean Claude Trinchet, NICOLAS SELLIER, Michel Beaugrand, Olivier Séror · 发表于：Hepatology · 年份：2009 · DOI：10.1002/hep.23181 · 被引用次数：457 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Genetic and Kidney Cyst Diseases、Liver Disease Diagnosis and Treatment

UNLABELLED: For the treatment of small hepatocellular carcinoma (HCC), radiofrequency ablation (RFA) is in some centers considered a first-line therapeutic option. However, such a strategy is still under debate with regard to tumor and patient characteristics. In this single-center study we assessed the 5-year survival and prognosis factors in 235 consecutive patients with cirrhosis (Child-Pugh A/B: 205/30) who received RFA as first-line treatment for up to three HCC <or=5 cm (307 tumors; mean diameter: 29 +/- 10 mm; 53 multinodular forms). Among these patients, 67 satisfied the criteria for resection according to the Barcelona Clinic Liver Cancer. Complete ablation was obtained in 222 patients (94%). Overall, 337 RFA sessions were performed including iterative RFA for recurrence. Major complications occurred in three patients (0.9%), including one treatment-related death. After 27 +/- 20 months of mean follow-up, local or distant, or both, tumor recurrence occurred in 16, 88, and 11 patients, respectively. Twenty-nine patients underwent transplantation and were removed from the study at this point. Overall 5-year, recurrence-free, and tumor-free (including results of iterative RFA) survival rates were, respectively, 40%, 17%, and 32%. The overall 5-year survival rate was 76% for operable patients. Factors associated with overall survival were prothrombin activity (hazard ratio [HR] = 0.97, 0.96-0.98; P < 0.0001) and serum levels of alpha-fetoprotein (AFP) (HR = 1.02, 1.02-1....