Predictors of survival after laparoscopic radiofrequency thermal ablation of hepatocellular cancer: a prospective study.
BACKGROUND
Most patients with hepatocellular carcinoma (HCC) are not candidates for hepatic resection or liver transplantation. Radiofrequency ablation (RFA) provides local control for unresectable HCC with minimal morbidity. The aim of this prospective study is to determine factors predicting survival in patients with HCC undergoing RFA.


METHODS
Sixty-six consecutive patients with HCC who were not candidates for a curative liver resection and were free of extrahepatic disease underwent laparoscopic RFA. The relationship between demographic, clinical, laboratory, and surgical parameters and survival was assessed using univariate Kaplan-Meier survival and multivariate Cox proportional hazards model.


RESULTS
The median Kaplan-Meier survival for all patients was 25.3 months after RFA. Although alfa fetal protein (AFP), bilirubin, ascites, and Child class were statistically significant predictors of survival by univariate analysis, only the Child class and AFP were independent predictors by multivariate analysis.


CONCLUSIONS
This study determines which patients do best after RFA and shows that RFA can provide significant survival for patients with unresectable HCC while also forming a bridge to liver transplantation. RFA has become the first line of treatment in the management of these patients.
Berber
E
E
Department of General Surgery, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Rogers
S
S
Siperstein
A
A
D000368:Aged; D001201:Ascites / Q000209:etiology; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006932:Hyperbilirubinemia / Q000209:etiology; D010535:Laparoscopy / Q000706:statistics & numerical data*; D015993:Life Tables; D008113:Liver Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index; D016019:Survival Analysis; D018084:Ultrasonography, Interventional; D000509:alpha-Fetoproteins / Q000032:analysis
D014408:Biomarkers, Tumor; D012709:Serum Albumin; D000509:alpha-Fetoproteins