title: Treatment of hepatocellular carcinoma in compensated cirrhosis with radio-frequency thermal ablation (RFTA): a prospective study.
abstract: 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.
authors.affiliation: Cattedra e Unità Operativa di Gastroenterologia, University of Palermo, Palermo, Italy. camma@ibim.cnr.it
authors.forename: Calogero
authors.initials: C
authors.lastname: Cammà
authors.forename: Vito
authors.initials: V
authors.lastname: Di Marco
authors.forename: Ambrogio
authors.initials: A
authors.lastname: Orlando
authors.forename: Luigi
authors.initials: L
authors.lastname: Sandonato
authors.forename: Andrea
authors.initials: A
authors.lastname: Casaril
authors.forename: Piero
authors.initials: P
authors.lastname: Parisi
authors.forename: Silvia
authors.initials: S
authors.lastname: Alizzi
authors.forename: Elio
authors.initials: E
authors.lastname: Sciarrino
authors.forename: Roberto
authors.initials: R
authors.lastname: Virdone
authors.forename: Salvatore
authors.initials: S
authors.lastname: Pardo
authors.forename: Danilo
authors.initials: D
authors.lastname: Di Bona
authors.forename: Anna
authors.initials: A
authors.lastname: Licata
authors.forename: Federica
authors.initials: F
authors.lastname: Latteri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cabibbo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Montalto
authors.forename: Mario Adelfio
authors.initials: MA
authors.lastname: Latteri
authors.forename: Nicola
authors.initials: N
authors.lastname: Nicoli
authors.forename: Antonio
authors.initials: A
authors.lastname: Craxì
mesh_terms: 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