Ten-year survival of hepatocellular carcinoma patients undergoing radiofrequency ablation as a first-line treatment

作     者：Wei Yang Kun Yan S Nahum Goldberg Muneeb Ahmed Jung-Chieh Lee Wei Wu Zhong-Yi Zhang Song Wang Min-Hua Chen 

作者机构：Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education)Department of UltrasoundPeking University Cancer Hospital and Institute Division of Image-guided TherapyDepartment of RadiologyHadassah Hebrew University Medical Center Laboratory for Minimally Invasive Tumor TherapiesDepartment of RadiologyBeth Israel Deaconess Medical Center/Harvard Medical School 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2016年第22卷第10期

页      面：2993-3005页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Supported by the National Natural Science Foundation of China No.81471768 the Natural Science Foundation of Beijing Municipality No.7152031 the Beijing Municipal Health System Special Funds of High-Level Medical Personnel Construction No.2013-3-086 

主　　题：Radiofrequency ablation Hepatocellular carcinoma Percutaneous Ultrasonography-guided Long term survival 

摘      要：AIM: To investigate the long-term survival and prognostic factors in hepatocellular carcinoma (HCC) patients undergoing radiofrequency ablation (RFA) as a first-line ***: From 2000 to 2013, 316 consecutive patients with 404 HCC (1.0-5.0 cm; mean: 3.2 ± 1.1 cm) underwent ultrasonography-guided percutaneous RFA as a first-line treatment. There were 250 males and 66 females with an average age of 60.1 ± 10.8 years (24-87 years). Patients were followed for 1 year to 10 years after RFA (234, 181, 136, and 71 for 3, 5, 7, and 10 years, respectively). Overall local response rates and long-term survival rates were assessed. Survival results were generated using Kaplan-Meier estimates, and multivariate analysis was performed using the Cox regression ***: In total, 548 RFA sessions were performed and major complications occurred in 10 sessions (1.8%). Local tumor progression and/or new tumor development were observed in 43.3% (132/305) of the patients during the follow-up period. Overall 5- and 10-year survival rates were 49.7% and 28.4%, respectively. Based on multivariate analysis, three factors were identified as independent prognostic factors for overall survival: Child-Pugh classification (HR = 4.054, P 0.001), portal vein hypertension (HR = 2.743, P = 0.002), and tumor number (HR = 2.693, P = 0.003). The local progression-free 5- and 10-year survival rates were 42.7% and 19.5%. In addition to the Child-Pugh classification and the number of tumors, the number of RFA sessions (HR = 1.550, P = 0.002) was associated with local progression-free ***: RFA can achieve acceptable outcomes for HCC patients as a first-line treatment, especially for patients with Child-Pugh class A, patients with a single tumor and patients without portal vein hypertension.