Title Ten-year survival of hepatocellular carcinoma patients undergoing radiofrequency ablation as a first-line treatment
Authors Yang, Wei
Yan, Kun
Goldberg, S. Nahum
Ahmed, Muneeb
Lee, Jung-Chieh
Wu, Wei
Zhang, Zhong-Yi
Wang, Song
Chen, Min-Hua
Affiliation Peking Univ, Canc Hosp & Inst, Key Lab Carcinogenesis & Translat Res, Minist Educ,Dept Ultrasound, 52 Fucheng Rd, Beijing 100142, Peoples R China.
Hadassah Hebrew Univ, Med Ctr, Dept Radiol, Div Image Guided Therapy, IL-91120 Jerusalem, Israel.
Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Lab Minimally Invas Tumor Therapies,Dept Radiol, Boston, MA 02215 USA.
Keywords Radiofrequency ablation
Hepatocellular carcinoma
Percutaneous
Ultrasonography-guided
Long term survival
CONTRAST-ENHANCED ULTRASOUND
GUIDED TUMOR ABLATION
PROGNOSTIC-FACTORS
REPORTING CRITERIA
LOCAL RECURRENCE
CIRRHOSIS
RESECTION
OUTCOMES
STANDARDIZATION
METAANALYSIS
Issue Date 2016
Publisher WORLD JOURNAL OF GASTROENTEROLOGY
Citation WORLD JOURNAL OF GASTROENTEROLOGY.2016,22,(10),2993-3005.
Abstract AIM: To investigate the long-term survival and prognostic factors in hepatocellular carcinoma (HCC) patients undergoing radiofrequency ablation (RFA) as a first-line treatment. METHODS: From 2000 to 2013, 316 consecutive patients with 404 HCC (1.0-5.0 cm; mean: 3.2 +/- 1.1 cm) underwent ultrasonography-guided percutaneous RFA as a first-line treatment. There were 250 males and 66 females with an average age of 60.1 +/- 10.8 years (24-87 years). Patients were followed for 1 year to > 10 years after RFA (234, 181, 136, and 71 for 3, 5, 7, and 10 years, respectively). Overall local response rates and long-term survival rates were assessed. Survival results were generated using Kaplan-Meier estimates, and multivariate analysis was performed using the Cox regression model. RESULTS: In total, 548 RFA sessions were performed and major complications occurred in 10 sessions (1.8%). Local tumor progression and/or new tumor development were observed in 43.3% (132/305) of the patients during the follow-up period. Overall 5and 10-year survival rates were 49.7% and 28.4%, respectively. Based on multivariate analysis, three factors were identified as independent prognostic factors for overall survival: Child-Pugh classification (HR = 4.054, P < 0.001), portal vein hypertension (HR = 2.743, P = 0.002), and tumor number (HR = 2.693, P = 0.003). The local progression-free 5- and 10-year survival rates were 42.7% and 19.5%. In addition to the Child-Pugh classification and the number of tumors, the number of RFA sessions (HR = 1.550, P = 0.002) was associated with local progression-free survival. CONCLUSION: RFA can achieve acceptable outcomes for HCC patients as a first-line treatment, especially for patients with Child-Pugh class A, patients with a single tumor and patients without portal vein hypertension.
URI http://hdl.handle.net/20.500.11897/438451
ISSN 1007-9327
DOI 10.3748/wjg.v22.i10.2993
Indexed SCI(E)
Appears in Collections: 北京肿瘤医院

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