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Long-Term Outcome of Percutaneous Ablation in Very Early-Stage Hepatocellular Carcinoma

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Purpose

The aim of this study was to investigate the long-term outcomes of percutaneous ablation (PA) of very early-stage hepatocellulcar carcinoma (HCC) with a multimodal strategy.

Methods

Written informed consent was obtained from all patients before treatment. Percutaneous ethanol injection (PEI) was performed for tumors in unfavorable locations; microwave ablation (MWA) was performed for tumors in favorable positions without a capsule; and radiofrequency ablation (RFA) was carried out in favorable tumors with a capsule. Since 2003, these advanced PA techniques have been used.

Results

Eighty-three patients with very early HCC were treated with PA, including 33 with PEI, 19 with MWA, and 31 with RFA. Initial complete response (CR) was achieved in 79 patients (95%). The mean follow-up period was 45 ± 27 months (range, 24–155 months). Late treatment failure was observed in eight patients (10%), which was significantly associated with tumor size (P = 0.046) and technique advancements (P = 0.009). Sustained CR was achieved in 51 patients (61%) at the end of follow-up. Major complications occurred in two patients (2%). The 1-, 3-, 5-, and 6-year disease-free survival rates were 87%, 69%, 62%, and 59%, respectively. The 1-, 3-, 5-, and 7-year overall survival rates were 94%, 88%, 78%, and 74%, respectively.

Conclusions

Treatment of very early-stage HCC using a multimodal strategy tailored to tumor characteristics achieves equivalent initial CR rates and long-term survival rates compared to surgical resection.

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery, Division of Interventional Ultrasound, The First Affiliated Hospital, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, China

    Ming Kuang & Ye Wang

  2. Department of Medical Ultrasonics, The First Affiliated Hospital, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, China

    Xiao-Yan Xie, Man-Xia Lin, Zuo-Feng Xu, Guang-Jian Liu & Ming-De Lu

  3. Department of Liver Surgery, Zhongshan Hospital, Liver Cancer Institute, Fudan University, Shanghai, China

    Cheng Huang

Authors
  1. Ming Kuang
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  2. Xiao-Yan Xie
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  3. Cheng Huang
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  4. Ye Wang
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  5. Man-Xia Lin
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  6. Zuo-Feng Xu
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  7. Guang-Jian Liu
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  8. Ming-De Lu
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Corresponding authors

Correspondence to Ming Kuang or Ming-De Lu.

Additional information

Synopsis

This study assessed different modalities of percutaneous ablation (PA) for the treatment of 83 patients with very early-stage hepatocellular carcinoma. PA produced results that were comparable to surgical resection in terms of initial response, complications, and overall survival.

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Kuang, M., Xie, XY., Huang, C. et al. Long-Term Outcome of Percutaneous Ablation in Very Early-Stage Hepatocellular Carcinoma. J Gastrointest Surg 15, 2165–2171 (2011). https://doi.org/10.1007/s11605-011-1716-2

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  • DOI: https://doi.org/10.1007/s11605-011-1716-2

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