Successful initial ablation therapy contributes to survival in patients with hepatocellular carcinoma.
OBJECTIVE
To evaluate the outcome predictors of percutaneous ablation therapy in patients with unresectable hepatocellular carcinoma (HCC), especially to identify whether the initial treatment response contributes to the survival of the patients.


METHODS
The study cohort included 153 patients with single (102) and two or three (51) HCC nodules 5 cm or less in maximum diameter. As an initial treatment, 110 patients received radiofrequency ablation and 43 patients received percutaneous ethanol injection.


RESULTS
The Kaplan-Meier estimates of overall 3- and 5-year survival rates were 75% and 59%, respectively. The log-rank test revealed statistically significant differences in the overall survivals according to Child-Pugh class (P = 0.0275), tumor size (P = 0.0130), serum albumin level (P = 0.0060), serum protein induced by vitamin K absence or antagonist II level (P = 0.0486), and initial treatment response (P = 0.0130). The independent predictors of survival were serum albumin level (risk ratio, 3.216; 95% CI, 1.407-7.353; P = 0.0056) and initial treatment response (risk ratio, 2.474; 95% CI, 1.076-5.692; P = 0.0330) based on the Cox proportional hazards regression models. The patients had a serum albumin level 3.5 g/dL and the 3- and 5-year survival rates of 86% and 82%.


CONCLUSIONS
In HCC patients treated with percutaneous ablation therapy, serum albumin level and initial treatment response are the independent outcome predictors.
Morimoto
Manabu
M
Gastroenterological Center, Yokohama City University Medical Center, Yokohama City 232-0024, Japan. morimoto@urahp.yokohama-cu.ac.jp
Numata
Kazushi
K
Sugimori
Kazuya
K
Shirato
Kazuhito
K
Kokawa
Atsushi
A
Oka
Hiroyuki
H
Hirasawa
Kingo
K
Koh
Ryonho
R
Nihommatsu
Hiromi
H
Tanaka
Katsuaki
K
D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012597:Sclerosing Solutions / Q000008:administration & dosage; D012709:Serum Albumin / Q000378:metabolism; D016896:Treatment Outcome
D012597:Sclerosing Solutions; D012709:Serum Albumin; D000431:Ethanol