Tumoral response factors after radiofrequency ablation of hepatocellular carcinoma in cirrhotic liver.
OBJECTIVE
Hepatocellular carcinoma (HCC) ablation by radiofrequency (RFA) is a novel technique with a great variety of methods whose efficacy and predictive factors have not been completely studied. Some of the main predictive factors in this type of treatment are analyzed in the present study.


METHODS
Ninety-three patients with hepatocellular carcinoma over cirrhosis, and with no indication for surgical resection were treated by RFA. Two different types of electrodes were used for RFA (refrigerated-"Cool-Tip" and perfusion with saline solution, the approach was percutaneous, by laparoscopy or laparotomy.


RESULTS
Overall survival at 1, 2 and 3 years was 88, 81, and 76%, with a free-disease survival (FDS) of 66, 31 and 17%, respectively. For tumors less than 3 cm, FDS at 1,2 and 3 years was 74, 44 and 30%, while for more than 3 cm in size FDS was 55, 12 and 0% (p = 0.02). FDS for HCC with one nodule was 70, 36 and 22%, and for more than one nodule it decreased to 50, 17 and 0% at 1, 2 and 3 years, respectively (p = 0.07). Surprisingly, the method employed for RFA has a main influence in FDS, with 0% at 3 years for perfusion electrodes and 26% for cool-tip electrodes at the same period.


CONCLUSIONS
In this series, overall survival at three years was relatively high; however, tumoral size, number of nodules and RFS method were independent variables associated with disease-free survival.
Calleja Kempin
J
J
General Surgery Department and Liver Transplantation Unit, Hospital General Gregorio Marañón, Universidad Complutense, Madrid, Spain.
Colón Rodríguez
A
A
Muro de la Fuente
A
A
Clemente Ricote
G
G
Prieto Martín
M
M
Santos Castro
L
L
Matilla Peña
A
A
Bañares Cañizares
R
R
Martín Baena
D
D
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000628:therapy*; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000628:therapy*; D008297:Male; D016019:Survival Analysis; D016896:Treatment Outcome