[Prognosis and risk factors for recurrence of small liver cancer after a single session of percutaneous radiofrequency ablation]

Jing-Lin Xia, Sheng-Long Ye, Jing-Huai Zou, Zheng-Gang Ren, Yu-Hong Gan, Yan-Hong Wang, Yi Chen, Ning-Ling Ge, Zhao-You Tang, Bing-Hui Yang
Ai Zheng, Aizheng, Chinese Journal of Cancer 2004, 23 (9): 977-80

BACKGROUND & OBJECTIVE: As a new technique of local therapy for liver cancer, radiofrequency ablation (RFA) was widely used these years in China. This study was to evaluate the treatment efficacy of RFA on primary liver cancer (PLC), identify the risk factors of recurrence, and determine the indications of RFA for PLC.

METHODS: Records of 94 primary small liver cancer patients underwent a single session of percutaneous RFA in Liver Cancer Institute/Zhongshan Hospital from Jan. 2001 to Dec. 2003 were reviewed retrospectively. Data analyses were performed using SPSS for windows Ver. 11.5 software.

RESULTS: With a median follow-up of 16 months affer RFA treatment, the cumulative survival rate of 94 patients was 85.5% at 1 year, and 75.6% at 2 years. The cumulative recurrence-free survival rate was 31.3% at 1 year, and 10.4% at 2 years. The total recurrence rate was 66.0% (62/94). Log-rank test revealed that tumor with diameter of >3 cm (P< 0.05), proximity to intrahepatic vessels (P < 0.01), and subcapsular location (P< 0.05) were related to tumor recurrence,while gender, Child-pugh class, alpha fetoprotein (AFP) concentration, and combination therapy with percutaneous ethanol injection were not related to tumor recurrence. Cox regression analysis indicated that tumor proximity to intrahepatic vessels (95%CI, 2.102-7.899; P=0.000), and subcapsular location (95%CI, 1.672-6.289; P=0.001)were associated independently with recurrence after RFA treatment. Severe complications occurred in 2 cases (2.1%), including 1 case of bile duct hemorrhage, 1 case of sub-diaphragm effusion. No RFA related death and other severe complications occurred.

CONCLUSIONS: RFA appears to be a safe treatment for liver cancer. Patients with tumor diameter of <or= 3 cm, no proximity to intrahepatic vessels, and subcapsular location may be the most suitable candidates for RFA.

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