Survival of Patients with Hepatocellular Carcinoma (HCC) Treated by Percutaneous Radio-Frequency Ablation (RFA) Is Affected by Complete Radiological Response

Abstract

BackgroundRadio-frequency ablation (RFA) has been employed in the treatment of Barcelona Clinic Liver Cancer (BCLC) early stage hepatocellular carcinoma (HCC) as curative treatments.AimTo assess the effectiveness and the safety of RFA in patients with early HCC and compensated cirrhosis.MethodsA cohort of 151 consecutive patients with early stage HCC (122 Child-Pugh class A and 29 class B patients) treated with RFA were enrolled. Clinical, laboratory and radiological follow-up data were collected from the time of first RFA.A single lesion was observed in 113/151 (74.8%), two lesions in 32/151 (21.2%), and three lesions in 6/151 (4%) of patients.ResultsThe overall survival rates were 94%, 80%, 64%, 49%, and 41% at 12, 24, 36, 48 and 60 months, respectively. Complete response (CR) at 1 month (p<0.0001) and serum albumin levels (p = 0.0004) were the only variables indipendently linked to survival by multivariate Cox model. By multivariate analysis, tumor size (p = 0.01) is the only variable associated with an increased likehood of CR.The proportion of major complications after treatment was 4%.ConclusionsRFA is safe and effective for managing HCC with cirrhosis, especially for patients with HCC ≤3 cm and higher baseline albumin levels. Complete response after RFA significantly increases survival.

High circulating microRNA-122 expression is a poor prognostic marker in patients with hepatitis B virus-related hepatocellular carcinoma who undergo radiofrequency ablation

“…Underlying liver function, reflected by Child-Pugh class, serum albumin level, or prothrombin time, has been reported to be an important prognostic factor for predicting OS in HCC patients who underwent RFA [29][30][31]. In the present study, circulating miR-122 levels negatively correlated with serum albumin levels, which reflected liver synthetic function.…”

Host antitumor resistance improved by the macrophage polarization in a chimera model of patients with HCC

“…As a control, scrambled ODN was administered to the chimeras under the same conditions. Tumor volume was measured with a microcaliper once a week for 6 weeks and expressed in mm 3 .…”

“…1 The management of HCC has substantially changed in the past few decades. Earlier, HCC was treated by surgical resection, but multifocal HCC often arise synchronously or metachronously as new tumors or as intrahepatic metastases of the primary cancer, leading to high mortality rates in HCC patients [2][3][4] ; therefore, new strategies to treat HCC are needed in addition to the current therapies.…”

Radiologische und nuklearmedizinische regionale Tumortherapien

“…B. 18 [11][12]. Insgesamt ist festzuhalten, dass die RFA häufig als ebenbürtiges oder alternatives Verfahren (je nach Größe der Herde) zur Resektion angesehen werden kannsowohl als mögliches Bridging-Verfahren vor Lebertransplantation als auch als Therapieverfahren bei Patienten, die keine Kandidaten für eine Lebertransplantation oder Resektion (o. g. Kriterien der exzellenten Leberfunktion nicht erfüllt) sind [13].…”