Author/Authors :
Calogero Cammà، نويسنده , , Vito Di Marco، نويسنده , , Ambrogio Orlando، نويسنده , , Luigi Sandonato، نويسنده , , Andrea Casaril، نويسنده , , Piero Parisi، نويسنده , , Silvia Alizzi، نويسنده , , Elio Sciarrino، نويسنده , , Roberto Virdone، نويسنده , , Salvatore Pardo، نويسنده , , Danilo Di Bona، نويسنده , , Anna Licata، نويسنده , , Federica Latteri، نويسنده , , Giuseppe Cabibbo، نويسنده , , Giuseppe Montalto، نويسنده , , Mario Adelfio Latteri، نويسنده , , Nicola Nicoli، نويسنده , , Antonio Craxi، نويسنده , , Unità Interdipartimentale Neoplasie Epatiche (U.I.N.E) Group، نويسنده ,
Abstract :
Background/Aims
To assess the effectiveness and the safety of radio-frequency thermal ablation (RFTA) in patients with hepatocellular carcinoma (HCC) ≤5 cm in compensated cirrhosis.
Methods
A cohort of 202 consecutive patients (165 Child-Pugh class A and 37 class B) was prospectively assessed. A single lesion was observed in 160/202 (79.2%), two lesions in 29/202 (14.3%), and three lesions in 13/202 (6.4%) of patients.
Results
Sixty-seven patients died. Survival rates were 80% at 12 months, 67% at 24 months and 57% at 30 months (Child-Pugh A 59% and Child-Pugh B 48%). By Cox regression analysis, survival was independently predicted by serum albumin levels ≥35 g/L, platelet count ≥100.000/mmc, tumor size ≤3 cm, complete response at 1 month and Barcelona Clinic Liver Cancer (BCLC) staging classification. Overall recurrence rates were 22, 38, and 44% at 12, 24, and 30 months, respectively. One procedure-related death occurred. The proportion of major complications after treatment was 3.9%.
Conclusions
A complete response after RFTA significantly increases survival. The longest survival is obtained in the presence of HCC ≤3 cm and of higher baseline albumin levels and platelet counts. BCLC staging classification is able to discriminate patients with good or poor prognosis.
