射频消融(RFTA)技术治疗处于肝硬化代偿期的肝细胞癌的前瞻性研究

来源 :世界核心医学期刊文摘(胃肠病学分册) | 被引量 : 0次 | 上传用户:wanghao521146
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Background/Aims: To assess the effectiveness and the safety of radio-frequenc y thermal ablation (RFTA) in patients with hepatocellular carcinoma(HCC) ≤5 cm in compensated cirrhosis.Methods: A cohort of 202 consecutive patients (165 Chil d-Pughclass A and 37 class B) was prospectively assessed. A single lesion was o bserved 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 p redicted by serum albumin levels ≥35 g/L, platelet count ≥100.000/mmc, tumor s ize ≤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, 2 4, and 30 months, respectively.One procedure-related death occurred. The propor tion of major complications after treatment was 3.9%. Conclusions: A complete r esponse after RFTA significantly increases survival. The longest survival is obt ained in the presence of HCC ≤3 cm and of higher baseline albumin levels and pl atelet counts. BCLC staging classification is able to discriminate patients with good or poor prognosis. Background / Aims: To assess the effectiveness and the safety of radio-frequenc y thermal ablation (RFTA) in patients with hepatocellular carcinoma (HCC) ≤ 5 cm in compensated cirrhosis. Methods: A cohort of 202 consecutive patients (165 Chil d-Pughclass A and 37 class B) were prospectively assessed. A single lesion was o bserved in 160/202 (79.2%), two lesions in 29/202 (14.3%), and three lesions in 13/202 (6.4%) of patients. Survival rates were 80% at 12 months, 67% at 24 months and 57% at 30 months. By Cox regression analysis, survival (Child-Pugh A 59% and Child-Pugh B 48% was independently p redicted by serum albumin levels ≥35 g / L, platelet count ≥100.000 / mmc, tumor s ize ≤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 proposition of major complications after treatment was 3.9%. Conclusions: A complete survival is obtined in the presence of HCC ≤ 3 cm and of higher baseline albumin levels and pl atelet counts. BCLC staging classification is able to discriminate patients with good or poor prognosis.
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