Predictive factors of survival and intrahepatic recurrence of hepatocellular carcinoma in cirrhosis after percutaneous ethanol injection: analysis of 71 patients

Castellano, Luigi; Calandra, Maria; Blanco, C. Del Vecchio; Sio, Ilario de

doi:10.1016/s0168-8278(97)80324-8

Cited by 85 publications

(54 citation statements)

References 42 publications

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“…Our study shows that patients with HCC and no advanced liver disease, assessed by high baseline albumin and platelet levels, may benefit from RFTA treatment. The finding that high baseline albumin level was associated with improvement in survival is in agreement with the results of our previous study on PEI [10], as well as those of the study by Castellano [12]. Although a limitation to our study is the lack of data on direct assessment of portal hypertension [13], an interesting finding was the observation that platelet counts, a well known surrogate marker of clinically relevant portal hypertension, proved to be a strong predictor of survival.…”

Section: Discussionsupporting

confidence: 91%

Treatment of hepatocellular carcinoma in compensated cirrhosis with radio-frequency thermal ablation (RFTA): a prospective study

Cammà

Marco

Orlando

et al. 2005

Journal of Hepatology

104

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Background/Aims: To assess the effectiveness and the safety of radio-frequency thermal ablation (RFTA) in patients with hepatocellular carcinoma (HCC) %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 R35 g/L, platelet count R100.000/mmc, tumor size %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 %3 cm and of higher baseline albumin levels and platelet counts. BCLC staging classification is able to discriminate patients with good or poor prognosis. q

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Section: Discussionsupporting

confidence: 91%

Treatment of hepatocellular carcinoma in compensated cirrhosis with radio-frequency thermal ablation (RFTA): a prospective study

Cammà

Marco

Orlando

et al. 2005

Journal of Hepatology

104

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“…However, this event is heterogeneously defined (distance from the main nodule, location in the same segment) and named. 17,[25][26][27] Although we have called it late failure, late recognition of failure, or lack of local disease control, it is usually termed local recurrence or local tumor progression. 12 Whatever term is used, it is obvious that the available imaging techniques cannot assure that a tumor has been successfully treated.…”

Section: Discussionmentioning

confidence: 99%

“…Late treatment failure refers to the detection of viable tumor during follow-up either within the treated nodule or within 2 cm of the surrounding parenchyma as previously reported. 17,18 Therefore, treatment failure includes early and late failure and represents the failure of treatment to achieve local disease control. Disease recurrence was defined as the appearance of HCC foci beyond this area in the absence of failure.…”

Section: Assessment Of Treatment Response and Follow-upmentioning

confidence: 99%

Initial response to percutaneous ablation predicts survival in patients with hepatocellular carcinoma

et al. 2004

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Outcome predictors in patients with hepatocellular carcinoma (HCC) who are treated with percutaneous ablation are ill defined, and it is unknown if successful therapy is associated with improved survival. In our study, 282 cirrhotic patients with early nonsurgical HCC were treated with percutaneous ablation during a 15-year period. Single tumors were seen in 244 patients, and 2 to 3 nodules were seen in 38 patients. Initial complete response was achieved in 192 patients and was independently related to the size of the main tumor (P ‫؍‬ .015) and tumor stage (P ‫؍‬ .0001) (<2 cm, 96%; 2.1-3 cm, 78%; >3 cm, 56%; 2-3 nodules, 46%). At the end of follow-up, 80 patients presented sustained complete response. The 1-, 3-, and 5-year survival rates were 87%, 51%, and 27%, respectively. The independent predictors of survival were Child-Turcotte-Pugh class (P ‫؍‬ .0001) and initial complete response (P ‫؍‬ .006). Child-Turcotte-Pugh class A patients with initial complete response achieved 42% survival at 5 years; this figure increased to 63% in patients with tumors 2 cm or smaller. In conclusion, our results demonstrate that initial complete response to percutaneous ablation is associated with an improved survival in both Child-Turcotte-Pugh class A and B patients with nonsurgical HCC. Accordingly, initial complete tumor necrosis should be considered a relevant therapeutic target irrespective of tumor size and liver function. (HEPATOLOGY 2004;40:1352-1360

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“…[30][31][32] In particular, percutaneous ethanol injection (PEI) into small HCCs has resulted in longterm survival rates similar to those achieved with the best surgical series. 32 The 5-year recurrence rates are also similar, ie, 57% to 100% [33][34][35][36][37] for the surgical series and 64% to 100% 32,[38][39][40] with PEI. If we take into account the minimal discomfort to patients and the low cost of a procedure like PEI, which is performed on an outpatient basis, it seems reasonable to conclude that PEI is actually the most appropriate treatment for HCCs.…”

Section: Commentmentioning

confidence: 97%

No-Mortality Liver Resection for Hepatocellular Carcinoma in Cirrhotic and Noncirrhotic Patients

et al. 1999

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Predictive factors of survival and intrahepatic recurrence of hepatocellular carcinoma in cirrhosis after percutaneous ethanol injection: analysis of 71 patients

Cited by 85 publications

References 42 publications

Treatment of hepatocellular carcinoma in compensated cirrhosis with radio-frequency thermal ablation (RFTA): a prospective study

Treatment of hepatocellular carcinoma in compensated cirrhosis with radio-frequency thermal ablation (RFTA): a prospective study

Initial response to percutaneous ablation predicts survival in patients with hepatocellular carcinoma

No-Mortality Liver Resection for Hepatocellular Carcinoma in Cirrhotic and Noncirrhotic Patients

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