Successful initial ablation therapy contributes to survival in patients with hepatocellular carcinoma

Abstract

AIM:To evaluate the outcome predictors of percutaneous ablation therapy in patients with unresectable hepatocellular carcinoma (HCC), especially to identify whether the initial treatment response contributes to the survival of the patients. METHODS:The study cohort included 153 patients with single (102) and two or three (51) HCC nodules 5 cm or less in maximum diameter. As an initial treatment, 110 patients received radiofrequency ablation and 43 patients received percutaneous ethanol injection. RESULTS:The Kaplan-Meier estimates of overall 3-and 5-year survival rates were 75% and 59%, respectively. The log-rank test revealed statistically significant differences in the overall survivals according to ChildPugh class (P = 0.0275), tumor size (P = 0.0130), serum albumin level (P = 0.0060), serum protein induced by vitamin K absence or antagonist Ⅱ level (P = 0.0486), and initial treatment response (P = 0.0130). The independent predictors of survival were serum albumin level (risk ratio, 3.216; 95% CI, 1.407-7.353; P = 0.0056) and initial treatment response (risk ratio, 2.474; 95% CI, 1.076-5.692; P = 0.0330) based on the Cox proportional hazards regression models. The patients had a serum albumin level 3.5 g/dL and the 3-and 5-year survival rates of 86% and 82%. C O N C L U S I O N :I n H C C p a t i e n t s t r e a t e d w i t h percutaneous ablation therapy, serum albumin level and initial treatment response are the independent outcome predictors.

Midterm outcomes in patients with intermediate‐sized hepatocellular carcinoma

“…43,44 However, in the present study, although there was a significant difference between the local tumor progression rates of the initially treated lesions in the TACE-RFA group and the RFA group, there were no differences between the overall survival rates in the 2 treatment groups. The enrolled patients were randomly assigned to 2 groups, which contained patients at a similar risk of overall recurrence; however, the discrepancy might be attributed to the relatively small number of patients and the relatively short follow-up period in this randomized trial.…”

Insufficient radiofrequency ablation therapy may induce further malignant transformation of hepatocellular carcinoma

“…Our data do not diminish the importance of RFA; however, these suggest that we should aim total cell kill in one session of RFA for HCC. More importantly, there are reports showing that the initial response to percutaneous ablation predicts survival in patients with HCC [26,27]. Our results provide an experimental basis for these clinical reports.…”

Effects of radiofrequency ablation versus other ablating techniques on hepatocellular carcinomas: a systematic review and meta-analysis

“…A random-effect model yielded an OR of 5.02 (95% CI 0.33–77.07) for data on the incidence of complications from two cohort studies [18, 20]. In the RCT, 7 of 180 patients in the CRA group and 6 of 180 patients in the RFA group had complications (OR 1.17, 95% CI 0.39–3.56).…”