Survival of patients with hepatocellular carcinoma (HCC) treated by percutaneous radio-frequency ablation (RFA) is affected by complete radiological response.
BACKGROUND
Radio-frequency ablation (RFA) has been employed in the treatment of Barcelona Clinic Liver Cancer (BCLC) early stage hepatocellular carcinoma (HCC) as curative treatments.


OBJECTIVE
To assess the effectiveness and the safety of RFA in patients with early HCC and compensated cirrhosis.


METHODS
A cohort of 151 consecutive patients with early stage HCC (122 Child-Pugh class A and 29 class B patients) treated with RFA were enrolled. Clinical, laboratory and radiological follow-up data were collected from the time of first RFA. A single lesion was observed in 113/151 (74.8%), two lesions in 32/151 (21.2%), and three lesions in 6/151 (4%) of patients.


RESULTS
The overall survival rates were 94%, 80%, 64%, 49%, and 41% at 12, 24, 36, 48 and 60 months, respectively. Complete response (CR) at 1 month (p<0.0001) and serum albumin levels (p = 0.0004) were the only variables indipendently linked to survival by multivariate Cox model. By multivariate analysis, tumor size (p = 0.01) is the only variable associated with an increased likehood of CR. The proportion of major complications after treatment was 4%.


CONCLUSIONS
RFA is safe and effective for managing HCC with cirrhosis, especially for patients with HCC ≤3 cm and higher baseline albumin levels. Complete response after RFA significantly increases survival.
Dipartimento Biomedico di Medicina Interna e Specialistica, Sezione di Gastroenterologia, Università di Palermo, Palermo, Italia. g.cab@libero.it
Giuseppe
G
Cabibbo
Marcello
M
Maida
Chiara
C
Genco
Nicola
N
Alessi
Marco
M
Peralta
Giuseppe
G
Butera
Massimo
M
Galia
Giuseppe
G
Brancatelli
Claudio
C
Genova
Maurizio
M
Raineri
Emanuele
E
Orlando
Simona
S
Attardo
Antonino
A
Giarratano
Massimo
M
Midiri
Vito
V
Di Marco
Antonio
A
Craxì
Calogero
C
Cammà
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005355:Fibrosis / Q000628:therapy; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome