Treatment of hepatocellular carcinoma in compensated cirrhosis with radio-frequency thermal ablation (RFTA): a prospective study.
OBJECTIVE
To assess the effectiveness and the safety of radio-frequency thermal ablation (RFTA) in patients with hepatocellular carcinoma (HCC) < or = 5 cm in compensated cirrhosis.


METHODS
A cohort of 202 consecutive patients (165 Child-Pugh class A and 37 class B) was prospectively assessed. A single lesion was observed in 160/202 (79.2%), two lesions in 29/202 (14.3%), and three lesions in 13/202 (6.4%) of patients.


RESULTS
Sixty-seven patients died. Survival rates were 80% at 12 months, 67% at 24 months and 57% at 30 months (Child-Pugh A 59% and Child-Pugh B 48%). By Cox regression analysis, survival was independently predicted by serum albumin levels > or = 35 g/L, platelet count > or = 100.000/mmc, tumor size < or = 3 cm, complete response at 1 month and Barcelona Clinic Liver Cancer (BCLC) staging classification. Overall recurrence rates were 22, 38, and 44% at 12, 24, and 30 months, respectively. One procedure-related death occurred. The proportion of major complications after treatment was 3.9%.


CONCLUSIONS
A complete response after RFTA significantly increases survival. The longest survival is obtained in the presence of HCC < or = 3 cm and of higher baseline albumin levels and platelet counts. BCLC staging classification is able to discriminate patients with good or poor prognosis.
Cammà
Calogero
C
Cattedra e Unità Operativa di Gastroenterologia, University of Palermo, Palermo, Italy. camma@ibim.cnr.it
Di Marco
Vito
V
Orlando
Ambrogio
A
Sandonato
Luigi
L
Casaril
Andrea
A
Parisi
Piero
P
Alizzi
Silvia
S
Sciarrino
Elio
E
Virdone
Roberto
R
Pardo
Salvatore
S
Di Bona
Danilo
D
Licata
Anna
A
Latteri
Federica
F
Cabibbo
Giuseppe
G
Montalto
Giuseppe
G
Latteri
Mario Adelfio
MA
Nicoli
Nicola
N
Craxì
Antonio
A
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy; D008103:Liver Cirrhosis / Q000401:mortality / Q000601:surgery*; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis