Treatment of hepatocellular carcinoma in compensated cirrhosis with radio-frequency thermal ablation (RFTA): a prospective study
- Autori: Camma', C.; DI MARCO, V.; Orlando, A.; Sandonato, L.; Casaril, A.; Parisi, P.; Alizzi, S.; Sciarrino, E.; Virdone, R.; Pardo, S.; DI BONA, D.; Licata, A.; Latteri, F.; Cabibbo, G.; Montalto, G.; Latteri, M.; Nicoli, N.; Craxi, A.; UNITA' INTERDIPARTIMENTALE NEOPLASIE EPATICHE UINE, G.
- Anno di pubblicazione: 2005
- Tipologia: Articolo in rivista (Articolo in rivista)
- Parole Chiave: Hepatocellular carcinoma, Radio frequency thermal ablation, Cirrhosis
- OA Link: http://hdl.handle.net/10447/17879
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.