Significant long-term survival after radiofrequency ablation of unresectable hepatocellular carcinoma in patients with cirrhosis

Chandrajit P. Raut, Francesco Izzo, Paolo Marra, Lee M. Ellis, Jean Nicolas Vauthey, Francesco Cremona, Paolo Vallone, Angelo Mastro, Bruno D. Fornage, Steven A. Curley

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

Background: Radiofrequency ablation (RFA) offers an alternative treatment in some unresectable hepatocellular carcinoma (HCC) patients with disease confined to the liver. We prospectively evaluated survival rates in patients with early-stage, unresectable HCC treated with RFA. Methods: All patients with HCC treated with RFA between September 1, 1997, and July 31, 2002, were prospectively evaluated. Patients were treated with RFA by using a percutaneous or open intraoperative approach with ultrasound guidance and were evaluated at regular intervals to determine disease recurrence and survival. Results: A total of 194 patients (153 men [79%] and 41 women [21%]) with a median age of 66 years (range, 39-86 years) underwent RFA of 289 sonographically detectable HCC tumors. All patients were followed up for at least 12 months (median follow-up, 34.8 months). Percutaneous and open intraoperative RFA was performed in 140 (72%) and 54 (28%) patients, respectively. The median diameter of tumors treated with RFA was 3.3 cm. Disease recurred in 103 (53%) of 194 patients, including 69 (49%) of 140 patients treated percutaneously and 34 (63%) of 54 treated with open RFA (not significant). Local recurrence developed in nine patients (4.6%). Most recurrence was intrahepatic. The overall complication rate was 12%. Overall survival rates at 1, 3, and 5 years for all 194 patients were 84.5%, 68.1%, and 55.4%, respectively. Conclusions: Treatment with RFA can produce significant long-term survival rates for cirrhotic patients with early-stage, unresectable HCC. RFA can be performed in these patients with relatively low complication rates. Confirmation of these results in randomized trials should be considered.

Original languageEnglish
Pages (from-to)616-628
Number of pages13
JournalAnnals of Surgical Oncology
Volume12
Issue number8
DOIs
Publication statusPublished - Aug 2005

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Hepatocellular Carcinoma
Fibrosis
Survival
Survival Rate
Recurrence
Neoplasms
Liver

Keywords

  • Cirrhosis
  • Hepatocellular cancer
  • Radiofrequency ablation
  • Survival
  • Unresectable

ASJC Scopus subject areas

  • Surgery
  • Oncology

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Significant long-term survival after radiofrequency ablation of unresectable hepatocellular carcinoma in patients with cirrhosis. / Raut, Chandrajit P.; Izzo, Francesco; Marra, Paolo; Ellis, Lee M.; Vauthey, Jean Nicolas; Cremona, Francesco; Vallone, Paolo; Mastro, Angelo; Fornage, Bruno D.; Curley, Steven A.

In: Annals of Surgical Oncology, Vol. 12, No. 8, 08.2005, p. 616-628.

Research output: Contribution to journalArticle

Raut, Chandrajit P. ; Izzo, Francesco ; Marra, Paolo ; Ellis, Lee M. ; Vauthey, Jean Nicolas ; Cremona, Francesco ; Vallone, Paolo ; Mastro, Angelo ; Fornage, Bruno D. ; Curley, Steven A. / Significant long-term survival after radiofrequency ablation of unresectable hepatocellular carcinoma in patients with cirrhosis. In: Annals of Surgical Oncology. 2005 ; Vol. 12, No. 8. pp. 616-628.
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abstract = "Background: Radiofrequency ablation (RFA) offers an alternative treatment in some unresectable hepatocellular carcinoma (HCC) patients with disease confined to the liver. We prospectively evaluated survival rates in patients with early-stage, unresectable HCC treated with RFA. Methods: All patients with HCC treated with RFA between September 1, 1997, and July 31, 2002, were prospectively evaluated. Patients were treated with RFA by using a percutaneous or open intraoperative approach with ultrasound guidance and were evaluated at regular intervals to determine disease recurrence and survival. Results: A total of 194 patients (153 men [79{\%}] and 41 women [21{\%}]) with a median age of 66 years (range, 39-86 years) underwent RFA of 289 sonographically detectable HCC tumors. All patients were followed up for at least 12 months (median follow-up, 34.8 months). Percutaneous and open intraoperative RFA was performed in 140 (72{\%}) and 54 (28{\%}) patients, respectively. The median diameter of tumors treated with RFA was 3.3 cm. Disease recurred in 103 (53{\%}) of 194 patients, including 69 (49{\%}) of 140 patients treated percutaneously and 34 (63{\%}) of 54 treated with open RFA (not significant). Local recurrence developed in nine patients (4.6{\%}). Most recurrence was intrahepatic. The overall complication rate was 12{\%}. Overall survival rates at 1, 3, and 5 years for all 194 patients were 84.5{\%}, 68.1{\%}, and 55.4{\%}, respectively. Conclusions: Treatment with RFA can produce significant long-term survival rates for cirrhotic patients with early-stage, unresectable HCC. RFA can be performed in these patients with relatively low complication rates. Confirmation of these results in randomized trials should be considered.",
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T1 - Significant long-term survival after radiofrequency ablation of unresectable hepatocellular carcinoma in patients with cirrhosis

AU - Raut, Chandrajit P.

AU - Izzo, Francesco

AU - Marra, Paolo

AU - Ellis, Lee M.

AU - Vauthey, Jean Nicolas

AU - Cremona, Francesco

AU - Vallone, Paolo

AU - Mastro, Angelo

AU - Fornage, Bruno D.

AU - Curley, Steven A.

PY - 2005/8

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N2 - Background: Radiofrequency ablation (RFA) offers an alternative treatment in some unresectable hepatocellular carcinoma (HCC) patients with disease confined to the liver. We prospectively evaluated survival rates in patients with early-stage, unresectable HCC treated with RFA. Methods: All patients with HCC treated with RFA between September 1, 1997, and July 31, 2002, were prospectively evaluated. Patients were treated with RFA by using a percutaneous or open intraoperative approach with ultrasound guidance and were evaluated at regular intervals to determine disease recurrence and survival. Results: A total of 194 patients (153 men [79%] and 41 women [21%]) with a median age of 66 years (range, 39-86 years) underwent RFA of 289 sonographically detectable HCC tumors. All patients were followed up for at least 12 months (median follow-up, 34.8 months). Percutaneous and open intraoperative RFA was performed in 140 (72%) and 54 (28%) patients, respectively. The median diameter of tumors treated with RFA was 3.3 cm. Disease recurred in 103 (53%) of 194 patients, including 69 (49%) of 140 patients treated percutaneously and 34 (63%) of 54 treated with open RFA (not significant). Local recurrence developed in nine patients (4.6%). Most recurrence was intrahepatic. The overall complication rate was 12%. Overall survival rates at 1, 3, and 5 years for all 194 patients were 84.5%, 68.1%, and 55.4%, respectively. Conclusions: Treatment with RFA can produce significant long-term survival rates for cirrhotic patients with early-stage, unresectable HCC. RFA can be performed in these patients with relatively low complication rates. Confirmation of these results in randomized trials should be considered.

AB - Background: Radiofrequency ablation (RFA) offers an alternative treatment in some unresectable hepatocellular carcinoma (HCC) patients with disease confined to the liver. We prospectively evaluated survival rates in patients with early-stage, unresectable HCC treated with RFA. Methods: All patients with HCC treated with RFA between September 1, 1997, and July 31, 2002, were prospectively evaluated. Patients were treated with RFA by using a percutaneous or open intraoperative approach with ultrasound guidance and were evaluated at regular intervals to determine disease recurrence and survival. Results: A total of 194 patients (153 men [79%] and 41 women [21%]) with a median age of 66 years (range, 39-86 years) underwent RFA of 289 sonographically detectable HCC tumors. All patients were followed up for at least 12 months (median follow-up, 34.8 months). Percutaneous and open intraoperative RFA was performed in 140 (72%) and 54 (28%) patients, respectively. The median diameter of tumors treated with RFA was 3.3 cm. Disease recurred in 103 (53%) of 194 patients, including 69 (49%) of 140 patients treated percutaneously and 34 (63%) of 54 treated with open RFA (not significant). Local recurrence developed in nine patients (4.6%). Most recurrence was intrahepatic. The overall complication rate was 12%. Overall survival rates at 1, 3, and 5 years for all 194 patients were 84.5%, 68.1%, and 55.4%, respectively. Conclusions: Treatment with RFA can produce significant long-term survival rates for cirrhotic patients with early-stage, unresectable HCC. RFA can be performed in these patients with relatively low complication rates. Confirmation of these results in randomized trials should be considered.

KW - Cirrhosis

KW - Hepatocellular cancer

KW - Radiofrequency ablation

KW - Survival

KW - Unresectable

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