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Prognostic factors and recurrence of hepatitis B-related hepatocellular carcinoma after argon-helium cryoablation: a prospective study

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Abstract

To determine the long-term prognosis of hepatocellular carcinoma (HCC) after argon-helium cryoablation and identify the risk factors that predict metastasis and recurrence. A total of 156 patients with hepatitis B-related HCC less than 5 cm in diameter who underwent curative cryoablation were followed up prospectively for tumor metastasis and recurrence. Immunohistochemistry was used to analyze the expression of vascular endothelial growth factor (VEGF). HBV basal core promoter (BCP) and precore mutations were detected by DNA sequence analysis. Post-treatment prognostic factors influencing survival, tumor metastasis and recurrence were assessed by univariate and multivariate analyses. The variables included the expression of VEGF in HCC tissues, clinical and pathologic characteristics of patients, and HBV features (HBV DNA level, HBV genotype, BCP mutation). The median follow-up period of the 156 patients was 37 months (range 8–48 months). The 1-, 2-, and 3-year overall survival rates were 92, 82 and 64%, respectively. The 1-, 2-, and 3-year recurrence-free survival rates were 72, 56 and 43%, respectively. Eighty-five patients (54.5%) had tumor recurrence or metastasis. The multivariate analysis showed that Child-Pugh class and the expression of VEGF in HCC tissues could be used as independent prognostic factors for overall survival. Meanwhile, the expression of VEGF in HCC tissues and HBV BCP mutations were found to be independent prognostic factors for recurrence-free survival. Strong expression of VEGF in HCC tissues and HBV BCP mutations are important risk predictors for recurrence or metastasis of HCC smaller than 5 cm in diameter.

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Abbreviations

CT:

Computed tomography

MRI:

Magnetic resonance imaging

PCR:

Polymerase chain reaction

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Acknowledgments

We would like to thank Le Li, Xiaodong Li (Infectious Disease Institute of PLA, Beijing 100039; China) for providing guidings in DNA sequence analysis. This research was supported by the Key Scientific and Technological Research Foundation of the National Special-purpose Program, grant number:2008ZX10002-018; and Medical Outstanding Foundation of Army, grant number:04J020.

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Authors and Affiliations

  1. Center of Therapeutic Research for Hepatocellular Carcinoma, 302 Hospital of PLA, 100039, Beijing, China

    Chunping Wang, Yinying Lu, Yan Chen, Yongyi Feng, Linjing An, Xinzhen Wang, Shuhui Su, Wenlin Bai, Lin Zhou & Yongping Yang

  2. Infectious Disease Institute of PLA, 100039, Beijing, China

    Dongping Xu

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  1. Chunping Wang
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  3. Yan Chen
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Correspondence to Yongping Yang.

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Wang, C., Lu, Y., Chen, Y. et al. Prognostic factors and recurrence of hepatitis B-related hepatocellular carcinoma after argon-helium cryoablation: a prospective study. Clin Exp Metastasis 26, 839–848 (2009). https://doi.org/10.1007/s10585-009-9283-6

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