Radiofrequency ablation of hepatocellular carcinoma: long-term outcome and prognostic factors.
OBJECTIVE
To investigate the efficacy of radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC), and the prognostic factors for post-RFA survival rate.


METHODS
From 1999 to 2006, 266 patients with 392 HCCs underwent ultrasound guided RFA treatment. They were 216 males and 50 females, average age 59.4+/-15.4 years (24-87 years). The HCC were 1.2-6.7 cm in diameters (average 3.9+1.3 cm). There were 158 patients with single tumor, and the rest had multiple (2-5) tumors. Univariate and multivariate analysis with 19 potential variables were examined to identify prognostic factors for post-RFA survival rate.


RESULTS
The overall post-RFA survival rates at 1st, 3rd, and 5th year were 82.9%, 57.9% and 42.9%, respectively. In the 60 patients with stage I HCC (AJCC staging), the 1-, 3-, 5-year survival rate were 94.8%, 76.4% and 71.6%, significantly higher than the 148 patients with stage II-IV tumors (81.8%, 57.6% and 41.2%, P=0.006). For the 58 patients with post-surgery recurrent HCC, the survival rates were 73.2%, 41.9% and 38.2% at the 1st, 3rd, and 5th year, which were significantly lower than those of stage I HCC (P=0.005). Nine potential factors were found with significant effects on survival rate, and they were number of tumors, location of tumors, pre-RFA liver function enzymes, Child-Pugh classification, AJCC staging, primary or recurrent HCC, tumor pathological grading, using mathematical protocol in RFA procedure and tumor necrosis 1 month after RFA. After multivariate analysis, three factors were identified as independent prognostic factors for survival rate, and they were Child-Pugh classification, AJCC staging and using mathematical protocol.


CONCLUSIONS
Identifying prognostic factors provides important information for HCC patient management before, during and after RFA. This long-term follow-up study on a large group of HCC patients confirmed that RFA could not only achieve favorable outcome on stage I HCC, but also be an effective therapy for stage II-IV or recurrent HCC.
Yan
Kun
K
Department of Ultrasound, Peking University School of Oncology, Beijing Cancer Hospital & Institute, No. 52 Fu-cheng Road, Hai-dian District, Beijing 100036, China.
Chen
Min Hua
MH
Department of Ultrasound, Peking University School of Oncology, Beijing Cancer Hospital & Institute, No. 52 Fu-cheng Road, Hai-dian District, Beijing 100036, China. Electronic address: minhuachen@bjcancer.org.
Yang
Wei
W
Department of Ultrasound, Peking University School of Oncology, Beijing Cancer Hospital & Institute, No. 52 Fu-cheng Road, Hai-dian District, Beijing 100036, China.
Wang
Yan Bin
YB
Department of Ultrasound, Peking University School of Oncology, Beijing Cancer Hospital & Institute, No. 52 Fu-cheng Road, Hai-dian District, Beijing 100036, China.
Gao
Wen
W
Department of Ultrasound, Peking University School of Oncology, Beijing Cancer Hospital & Institute, No. 52 Fu-cheng Road, Hai-dian District, Beijing 100036, China.
Hao
Chun Yi
CY
Department of Ultrasound, Peking University School of Oncology, Beijing Cancer Hospital & Institute, No. 52 Fu-cheng Road, Hai-dian District, Beijing 100036, China.
Xing
Bao Cai
BC
Department of Surgery, Peking University School of Oncology, Beijing Cancer Hospital & Institute, No. 52 Fu-cheng Road, Hai-dian District, Beijing 100036, China.
Huang
Xin Fu
XF
Department of Surgery, Peking University School of Oncology, Beijing Cancer Hospital & Institute, No. 52 Fu-cheng Road, Hai-dian District, Beijing 100036, China.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D015996:Survival Rate; D016896:Treatment Outcome