title: Long-term outcomes of percutaneous cryoablation for patients with hepatocellular carcinoma within Milan criteria.
abstract: BACKGROUND
  Accumulating evidences have suggested that percutaneous cryoablation could be a valuable alternative ablation therapy for HCC but there has been no large cohort-based analysis on its long-term outcomes.
  
  
  METHODS
  A series of 866 patients with Child-Pugh class A-B cirrhosis and HCC within Milan criteria who underwent percutaneous cryoablation was long-term followed. The safety, efficacy, 5-year survival, and prognostic factors of percutaneous cryoablation in the treatment of HCC were analyzed.
  
  
  RESULTS
  A total of 1197 HCC lesions were ablated with 1401 cryoablation sessions. Complete response (CR) was achieved in 1163 (97.2%) lesions and 832 (96.1%) patients with 34 (2.8%) major complications, but no treatment-related mortality. After a median of 30.9 months follow-up, 502 (60.3%) patients who achieved CR developed different types of recurrence. The cumulative local tumor recurrence rate was 24.2% at 5-years. Multiple tumor lesions, tumor size > 3 cm, and repeated ablation of same lesion were independent risk factors associated with local recurrence. The 5-year overall survival (OS) rates were 59.5%. Age < 36 years, HCC family history, baseline hepatitis B virus DNA >106 copies/ml, and three HCC lesions were independently and significantly negative predictors to the post-cryoablation OS.
  
  
  CONCLUSIONS
  Percutaneous cryoablation is an effective therapy for patients with HCC within Milan criteria, with comparable efficacy, safety and long-term survival to the reported outcomes of radiofrequency ablation.
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Guanghua
authors: G
authors: Rong
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Wenlin
authors: W
authors: Bai
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Zheng
authors: Z
authors: Dong
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Chunping
authors: C
authors: Wang
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Yinying
authors: Y
authors: Lu
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Zhen
authors: Z
authors: Zeng
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Jianhui
authors: J
authors: Qu
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Min
authors: M
authors: Lou
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Hong
authors: H
authors: Wang
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Xudong
authors: X
authors: Gao
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Xiujuan
authors: X
authors: Chang
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Linjing
authors: L
authors: An
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Hongyan
authors: H
authors: Li
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Yan
authors: Y
authors: Chen
authors: Division of Gastroenterology/Hepatology, University of California, Irvine, 101 the City Dr., Building 56, Ste. 237, Orange, CA 92868, United States of America.
authors: Ke-Qin
authors: KQ
authors: Hu
authors: Center of Therapeutic Research for Liver Cancer, the 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
authors: Yongping
authors: Y
authors: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery*; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult