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Long-term Follow-up Outcome of Patients Undergoing Radiofrequency Ablation for Unresectable Hepatocellular Carcinoma

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Abstract

The long-term outcome of radiofrequency thermal ablation (RFA) for unresectable hepatocellular carcinoma (HCC) has not been reported. This study was performed to evaluate the long-term survival of patients with unresectable HCC after RFA and to identify possible factors that might affect survival. In this prospective study, 65 patients with unresectable HCC who underwent RFA were followed. A total of 84 RFA operations were performed percutaneously (n = 49), laparoscopically (n = 20), or by open surgery (n = 15), to ablate 191 tumors. Twenty-two patients died within 16 months; otherwise, the follow-up period was at least 16 months, up to 71 months, with median 20.0 months and mean (± standard deviation) 24.8 ± 18.4 months for all patients. Local tumor recurrence developed in 12 of 191 tumors (6.3%) in 11 of 84 operations (13.1%), or 11 of 65 patients (16.9%). New liver and/or extrahepatic recurrence developed in 48 operations (57.1%). The overall median, mean, and 5-year survivals were 40.0 months, 33.7 ± 2.9 months, and 39.9%. The disease-free survivals were 16.0 month, 32.9 ± 3.0 months, and 27.9%. Factors that had a significant effect on survival outcome after RFA were TNM cancer stage and the operative approach method employed for RFA. Age, gender, race, etiology, alpha-fetoprotein, previous or subsequent treatment, and liver function (Child-Pugh class) did not affect survival. For patients with unresectable HCC, RFA is an effective and repeatable local treatment that can afford long-term survival, although often with disease recurrence.

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References

  1. Rossi S, Di Stasi M, Buscarini E, et al. Percutaneous radiofrequency interstitial thermal ablation in the treatment of small hepatocellular carcinoma. Cancer J Sci Am 1995;1:73–81

    PubMed  Google Scholar 

  2. Rossi S, Di Stasi M, Buscarini E, et al. Percutaneous RF interstitial thermal ablation in the treatment of hepatic cancer. A.J.R. Am J Roentgenol 1996;167:759–768

    PubMed  CAS  Google Scholar 

  3. Allgaier HP, Deibert P, Zuber I, et al. Percutaneous radiofrequency interstitial thermal ablation of small hepatocellular carcinoma. Lancet 1999;353:1676–1677

    Article  PubMed  CAS  Google Scholar 

  4. Jiao LR, Hansen PD, Havlik R, et al. Clinical short-term results of radiofrequency ablation in primary and secondary liver tumors. Am J Surg 1999;177:303–306

    Article  PubMed  CAS  Google Scholar 

  5. Livraghi T, Goldberg SN, Lazzaroni S, et al. Hepatocellular carcinoma: radio-frequency ablation of medium and large lesions. Radiology 2000;214:761–768

    PubMed  CAS  Google Scholar 

  6. Bilchik AJ, Rose DM, Allegra DP, et al. Radiofrequency ablation: a minimally invasive technique with multiple applications. Cancer J Sci Am 1999;5:356–361

    PubMed  CAS  Google Scholar 

  7. Siperstein A, Garland A, Engle K, et al. Local recurrence after laparoscopic radiofrequency thermal ablation of hepatic tumors. Ann Surg Oncol 2000;7:106–113

    Article  PubMed  CAS  Google Scholar 

  8. Curley SA, Izzo F, Ellis LM, et al. Radiofrequency ablation of hepatocellular cancer in 110 patients with cirrhosis. Ann Surg 2000;232:381–391

    PubMed  CAS  Google Scholar 

  9. Seidenfeld J, Korn A, Aronson N. Radiofrequency ablation of unresectable primary liver cancer. J. Am. Coll. Surg. 2002;194:813–828

    Article  PubMed  Google Scholar 

  10. Seidenfeld J, Korn A, Aronson N. Radiofrequency ablation of unresectable liver metastases. J Am Coll Surg 2002;195:378–386

    Article  PubMed  Google Scholar 

  11. Poon RT, Fan ST, Tsang FH, et al. Locoregional therapies for hepatocellular carcinoma: a critical review from the surgeon’s perspective. Ann Surg 2002;235:466–486

    Article  PubMed  Google Scholar 

  12. Livraghi T, Goldberg SN, Lazzaroni S, et al. Small hepatocellular carcinoma: treatment with radio-frequency ablation versus ethanol injection. Radiology 1999;210:655–661

    PubMed  CAS  Google Scholar 

  13. Lencioni RA, Allgaier HP, Cioni D, et al. Small hepatocellular carcinoma in cirrhosis: randomized comparison of radio-frequency thermal ablation versus percutaneous ethanol injection. Radiology 2003;228:235–240

    PubMed  Google Scholar 

  14. Buscarini L, Buscarini E, Di Stasi M, et al. Percutaneous radiofrequency thermal ablation combined with transcatheter arterial embolization in the treatment of large hepatocellular carcinoma. Ultraschall Med 1999;20:47–53

    Article  PubMed  CAS  Google Scholar 

  15. Nicoli N, Casaril A, Marchiori L, et al. Intraoperative and percutaneous radiofrequency thermal ablation in the treatment of hepatocellular carcinoma. Chir Ital 2000;52:29–40

    PubMed  CAS  Google Scholar 

  16. Machi J, Uchida S, Sumida K, et al. Ultrasound-guided radiofrequency thermal ablation of liver tumors: percutaneous, laparoscopic, and open surgical approaches. J Gastrointest Surg 2001;5:477–489

    Article  PubMed  CAS  Google Scholar 

  17. Bowles BJ, Machi J, Limm WM, et al. Safety and efficacy of radiofrequency thermal ablation in advanced liver tumors. Arch Surg 2001;136:864–869

    PubMed  CAS  Google Scholar 

  18. Guglielmi A, Ruzzenente A, Battocchia A, et al. Radiofrequency ablation of hepatocellular carcinoma in cirrhotic patients. Hepatogastroenterology 2003;50:480–484

    PubMed  Google Scholar 

  19. Tang ZY, Yu YQ, Zhou XD. Evolution of surgery in the treatment of hepatocellular carcinoma from the 1950s to the 1990s. Semin Surg Oncol 1993;9:293–297

    PubMed  CAS  Google Scholar 

  20. Fong Y, Sun RL, Jarnagin W, et al. An analysis of 412 cases of hepatocellular carcinoma at a Western center. Ann Surg 1999;229:790–799

    Article  PubMed  CAS  Google Scholar 

  21. Poon RT, Fan ST, Lo CM, et al. Long-term prognosis after resection of hepatocellular carcinoma associated with hepatitis B-related cirrhosis. J Clin Oncol 2000;18:1094–1101

    PubMed  CAS  Google Scholar 

  22. Zhou XD, Tang ZY, Yang BH, et al. Experience of 1000 patients who underwent hepatectomy for small hepatocellular carcinoma. Cancer. 2001;91:1479–1486

    Article  PubMed  CAS  Google Scholar 

  23. Cha CH, Ruo L, Fong Y, et al. Resection of hepatocellular carcinoma in patients otherwise eligible for transplantation. Ann Surg 2003;238:315–323

    PubMed  Google Scholar 

  24. Aoki T, Imamura H, Kokudo N, et al. Updated data of management of hepatocellular carcinoma. Rinsho-Geka 2002;57(suppl):179–193 (in Japanese)

    Google Scholar 

  25. Lau WY, Leung TW, Yu SC, et al. Percutaneous local ablative therapy for hepatocellular carcinoma: a review and look into the future. Ann Surg 2003;237:171–179

    Article  PubMed  CAS  Google Scholar 

  26. Livraghi T, Giorgio A, Marin G, et al. Hepatocellular carcinoma and cirrhosis in 746 patients: long-term results of percutaneous ethanol injection. Radiology 1995;197:101–108

    PubMed  CAS  Google Scholar 

  27. Lencioni R, Pinto F, Armillotta N, et al. Long-term results of percutaneous ethanol injection therapy for hepatocellular carcinoma in cirrhosis: a European experience. Eur Radiol 1997;7:514–519

    Article  PubMed  CAS  Google Scholar 

  28. Seki T, Wakabayashi M, Nakagawa T, et al. Percutaneous microwave coagulation therapy for patients with small hepatocellular carcinoma: comparison with percutaneous ethanol injection therapy. Cancer 1999;85:1694–1702

    Article  PubMed  CAS  Google Scholar 

  29. Buscarini L, Buscarini E, Di Stasi M, et al. Percutaneous radiofrequency ablation of small hepatocellular carcinoma: long-term results. Eur Radiol 2001;11:914–921

    Article  PubMed  CAS  Google Scholar 

  30. Giovannini M, Moutardier V, Danisi C, et al. Treatment of hepatocellular carcinoma using percutaneous radiofrequency thermoablation: results and outcomes in 56 patients. J Gastrointest Surg 2003;7:791–796

    Article  PubMed  Google Scholar 

  31. El-Serag HB, Mason AC, Key C. Trends in survival of patients with hepatocellular carcinoma between 1977 and 1996 in the United States. Hepatology 2001;33:62–65

    Article  PubMed  CAS  Google Scholar 

  32. Lencioni R, Cioni D, Crocetti L, et al. Early-stage hepatocellular carcinoma in patients with cirrhosis: long-term results of percutaneous image-guided radiofrequency ablation. Radiology 2005;234:961–96

    PubMed  Google Scholar 

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Acknowledgments

This study was supported by Surgical Education, Inc, Honolulu, HI.

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Correspondence to Junji Machi MD, PhD.

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Machi, J., Bueno, R.S. & Wong, L.L. Long-term Follow-up Outcome of Patients Undergoing Radiofrequency Ablation for Unresectable Hepatocellular Carcinoma. World J. Surg. 29, 1364–1373 (2005). https://doi.org/10.1007/s00268-005-7829-6

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  • DOI: https://doi.org/10.1007/s00268-005-7829-6

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