title: Percutaneous radiofrequency ablation for early-stage hepatocellular carcinoma as a first-line treatment: long-term results and prognostic factors in a large single-institution series.
abstract: The purpose of this study was to evaluate the long-term survival results and complications of percutaneous radiofrequency ablation (RFA) in patients with early-stage hepatocellular carcinoma (HCC). Between April 1999 and May 2005, 570 patients with 674 early-stage HCCs underwent percutaneous RFA as a first-line treatment option in a single institution. We evaluated the effectiveness rates, local tumor progression rates, survival rates, and complications. We also assessed the prognostic values of survival rates by using Cox proportional hazard models. The primary technique effectiveness rate was 96.7% (652 of 674). The cumulative rates of local tumor progression at 1, 2, and 3 years were 8.1%, 10.9%, and 11.8%, respectively. The cumulative survival rates at 1, 2, 3, 4, and 5 years were 95.2%, 82.9%, 69.5%, 60.8%, and 58.0%, respectively. Patients with Child-Pugh class A cirrhosis, of younger age (<or=58 years), or having lower AFP level (<or=100 microg/L) demonstrated better survival results (P < 0.05). A total of 11 major complications (1.9% per treatment) were found during the follow-up period. There was no procedure-related death. Percutaneous RFA can be used successfully as a first-line treatment modality for early-stage HCCs. Child-Pugh class, age, and AFP level before RFA were significant prognostic predictors of long-term survival.
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul, 135-710, South Korea.
authors.forename: Dongil
authors.initials: D
authors.lastname: Choi
authors.forename: Hyo K
authors.initials: HK
authors.lastname: Lim
authors.forename: Hyunchul
authors.initials: H
authors.lastname: Rhim
authors.forename: Young-Sun
authors.initials: YS
authors.lastname: Kim
authors.forename: Won Jae
authors.initials: WJ
authors.lastname: Lee
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Paik
authors.forename: Kwang Cheol
authors.initials: KC
authors.lastname: Koh
authors.forename: Joon Hyoek
authors.initials: JH
authors.lastname: Lee
authors.forename: Moon Seok
authors.initials: MS
authors.lastname: Choi
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Yoo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D011379:Prognosis; D016016:Proportional Hazards Models; D015996:Survival Rate; D016896:Treatment Outcome