title: Radiofrequency ablation of hepatocellular carcinoma in patients with and without cirrhosis.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) is a leading cause of death in patients with cirrhosis. Around 12% of all cases are associated with chronic liver disease without cirrhosis. The aim of our study was to compare primary tumor ablation rates, local tumor progression, safety, and long-term outcomes of radiofrequency ablation for single (less than 3.5 cm in diameter) or multiple HCC nodules (up to three nodules, each less than 3 cm) in both types of patients.
  
  
  METHODS
  We treated 200 consecutive HCC patients recruited from a local sonographic screening program: 175 with cirrhosis and 25 with non-cirrhotic chronic liver disease.
  
  
  RESULTS
  Complete ablation was achieved in 150 of the 175 patients (85.7%) (174 of the 206 nodules treated, 84.4%) in the cirrhotic group and in 24 of the 25 patients (96%) (27 of the 29 nodules treated; 93%) in the non-cirrhotic group. The two groups were not significantly different in terms of local tumor progression rates 1, 3, and 5 years after treatment (11%, 23%, and 24% among cirrhotics vs. 4%, 14%, and 14% among non-cirrhotic patients). Multifocal disease was more frequent among the cirrhotics. One-, three- and five-year survival rates were also similar in the cirrhotic (93%, 77%, and 61%) and non-cirrhotic groups (92%, 72%, and 64%). There were no treatment-related deaths. Severe complications occurred only in the cirrhotic group (2.2%).
  
  
  CONCLUSIONS
  Radiofrequency ablation is safe and effective treatment for HCC in patients with or without cirrhosis. The latter group has a significantly lower rate of multifocal disease.
authors: Gastroenterology Unit, Sant'Orsola Fatebenefratelli Hospital, Brescia, Italy.
authors: A
authors: A
authors: Salmi
authors: R
authors: R
authors: Turrini
authors: G
authors: G
authors: Lanzani
authors: A
authors: A
authors: Savio
authors: L
authors: L
authors: Anglani
keywords: Chronic liver disease; Cirrhosis; Efficacy; Hepatocellular carcinoma; Radiofrequency ablation; Survival; Therapy; Ultrasound
references: Gastroenterology. 2005 Jul;129(1):122-30
references: 16012942
references: Hepatology. 1995 Mar;21(3):650-5
references: 7875662
references: Ann Surg. 1998 Mar;227(3):424-32
references: 9527066
references: Radiology. 2000 Dec;217(3):633-46
references: 11110923
references: Radiology. 1999 Mar;210(3):655-61
references: 10207464
references: J Hepatol. 2003 Dec;39(6):1076-84
references: 14642630
references: Arch Surg. 2006 Feb;141(2):181-90
references: 16490897
references: Ann Surg. 2005 Aug;242(2):158-71
references: 16041205
references: Hepatology. 1994 Jun;19(6):1513-20
references: 8188183
references: Hepatology. 2008 Jan;47(1):82-9
references: 18008357
references: Hepatology. 2005 May;41(5):1130-7
references: 15841454
references: Gut. 2001 Feb;48(2):251-9
references: 11156649
references: Cancer Epidemiol Biomarkers Prev. 2000 Feb;9(2):213-6
references: 10698484
references: AJR Am J Roentgenol. 1998 Apr;170(4):1015-22
references: 9530052
references: Hepatogastroenterology. 2008 Jan-Feb;55(81):191-6
references: 18507105
references: J Hepatol. 2005 Sep;43(3):458-64
references: 16005538
references: Gut. 2005 Aug;54(8):1151-6
references: 16009687
references: Hepatology. 2005 Nov;42(5):1208-36
references: 16250051
references: Hepatology. 2002 Mar;35(3):519-24
references: 11870363
references: J Clin Gastroenterol. 2005 Mar;39(3):247-52
references: 15718869