title: Long-term effectiveness of radiofrequency ablation for solitary small hepatocellular carcinoma: a retrospective analysis of 363 patients.
abstract: BACKGROUND
  Radiofrequency Ablation is the most widely performed percutaneous treatment for Hepatocellular Carcinoma. This multicentre study was aimed at assessing the complication, overall survival and disease-free survival rates in cirrhotic patients with single Hepatocellular Carcinoma nodule ≤3 cm undergoing Radiofrequency Ablation.
  
  
  METHODS
  Data of 365 patients (59% males; mean age 67 ± 8 years), Child-Pugh A/B, with single Hepatocellular Carcinoma nodule ≤3 cm (tumours >2-3 cm = 127/236), showing complete necrosis after Radiofrequency Ablation between 1998 and 2010 in 7 Italian Centers were retrospectively reviewed. Complication, overall survival and disease-free survival rates were analyzed as main clinical end-points.
  
  
  RESULTS
  Major complications were observed in 8 patients (2.2%) and minor complications in 23 patients (6.3%). The 3-, and 5-year overall survival rates were 80% and 64%. One hundred and seven patients (29.5%) died, being 41 deaths (38.3%) Hepatocellular Carcinoma-related. At multivariate analysis only age (p = 0.04; OR 2.29), ascites (p < 0.001; OR 3.74) and Child-Pugh class ≥B8 (p = 0.003; OR 2.42) were confirmed as independent predictors for overall survival. The disease-free survival rates at 3- and 5-year were 50%, and 41.8%.
  
  
  CONCLUSIONS
  Radiofrequency Ablation is an effective and safe tool for the treatment of single Hepatocellular Carcinoma ≤3 cm providing excellent 5-year overall survival and disease-free survival rates. Patient's age and liver status appeared as main determinants of outcome.
authors.affiliation: Diagnostic and Interventional Unit, S. Maria della Pietà Camilliani Hospital, Via San Rocco 9, 80026 Casoria, Italy. giampierofrancica@gmail.com
authors.forename: Giampiero
authors.initials: G
authors.lastname: Francica
authors.forename: Antonio
authors.initials: A
authors.lastname: Saviano
authors.forename: Ilario
authors.initials: I
authors.lastname: De Sio
authors.forename: Nicoletta
authors.initials: N
authors.lastname: De Matthaeis
authors.forename: Franco
authors.initials: F
authors.lastname: Brunello
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cantamessa
authors.forename: Antonio
authors.initials: A
authors.lastname: Giorgio
authors.forename: Umberto
authors.initials: U
authors.lastname: Scognamiglio
authors.forename: Fabio
authors.initials: F
authors.lastname: Fornari
authors.forename: Francesco
authors.initials: F
authors.lastname: Giangregorio
authors.forename: Fabio
authors.initials: F
authors.lastname: Piscaglia
authors.forename: Silvia
authors.initials: S
authors.lastname: Gualandi
authors.forename: Eugenio
authors.initials: E
authors.lastname: Caturelli
authors.forename: Paola
authors.initials: P
authors.lastname: Roselli
authors.forename: Gian Ludovico
authors.initials: GL
authors.lastname: Rapaccini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
mesh_terms: D000367:Age Factors; D000368:Aged; D001201:Ascites / Q000209:etiology; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000556:secondary / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D016017:Odds Ratio; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors