Delay in treatment of early-stage hepatocellular carcinoma using radiofrequency ablation may impact survival of cirrhotic patients in a surveillance program.
BACKGROUND
The aim of this study was to evaluate the impact of the interval between diagnosis and treatment using radiofrequency (RF) ablation on the survival of patients with HCC detected through a surveillance program.


METHODS
Between January 2004 and July 2007, 121 cirrhotic patients with 157 tumours detected through a surveillance program underwent RF ablation. A delay in treatment was defined as >5 weeks. The mean length of follow-up was 25 months (range 8-55 months). Cumulative survival of patients was analysed using the Kaplan-Meier method. Cox regression models were used to identify factors associated with patient survival.


RESULTS
The 1-, 2- and 3-year survival rates were 92.5%, 78.5% and 67.2%. The independent predictors of poorer patient survival were time from diagnosis to treatment >5 weeks (pooled odds ratio [OR], 3.59; 95% confidence interval [CI], 1.58-8.18; P = 0.002), absence of complete ablation after the initial RF session (OR, 2.42; 95% CI 1.07-5.45; P = 0.033) and Child-Pugh B liver cirrhosis (OR, 2.46; 95% CI 1.06-5.70; P = 0.036).


CONCLUSIONS
Delay in the start of effective treatment for HCC using RF ablation may be associated with poorer patient survival.
Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.
Wei-Ting
WT
Chen
Mark Lee
ML
Fernandes
Chen-Chun
CC
Lin
Shi-Ming
SM
Lin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D017115:Catheter Ablation; D002908:Chronic Disease; D015897:Comorbidity; D016001:Confidence Intervals; D057210:Delayed Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D015996:Survival Rate