Treatment of hepatocellular carcinoma in compensated cirrhosis with radio-frequency thermal ablation (RFTA): a prospective study
Calogero Cammà, Vito Di Marco, Ambrogio Orlando, Luigi Sandonato, Andrea Casaril, Piero Parisi, Silvia Alizzi, Elio Sciarrino, Roberto Virdone, Salvatore Pardo, Danilo Di Bona, Anna Licata, Federica Latteri, Giuseppe Cabibbo, Giuseppe Montalto, Mario Adelfio Latteri, Nicola Nicoli, Antonio Craxì, Unità Interdipartimentale Neoplasie Epatiche (U.I.N.E) Group, Calogero Cammà, Vito Di Marco, Ambrogio Orlando, Luigi Sandonato, Andrea Casaril, Piero Parisi, Silvia Alizzi, Elio Sciarrino, Roberto Virdone, Salvatore Pardo, Danilo Di Bona, Anna Licata, Federica Latteri, Giuseppe Cabibbo, Giuseppe Montalto, Mario Adelfio Latteri, Nicola Nicoli, Antonio Craxì, Unità Interdipartimentale Neoplasie Epatiche (U.I.N.E) Group
Abstract
Background/aims: To assess the effectiveness and the safety of radio-frequency thermal ablation (RFTA) in patients with hepatocellular carcinoma (HCC) < or = 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 > or = 35 g/L, platelet count > or = 100.000/mmc, tumor size < or = 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 < or = 3 cm and of higher baseline albumin levels and platelet counts. BCLC staging classification is able to discriminate patients with good or poor prognosis.
Source: PubMed