Document Detail


Analysis of factors predicting survival in patients with hepatocellular carcinoma treated with percutaneous laser ablation.
MedLine Citation:
PMID:  16545480     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: The factors which predict the long-term outcome in patients with hepatocellular carcinoma who are treated with percutaneous laser ablation (PLA) are not well established. METHODS: We prospectively analyzed treatment and survival parameters of 148 cirrhotic patients with nonsurgical hepatocellular carcinoma who had undergone PLA at a single institution during an 11-year period. RESULTS: Single tumors were seen in 129 of 148 (87%) patients, and 2-3 nodules were seen in 19 (13%) patients, for a total of 169 tumors. The median overall time survival was 39 months (95% confidence interval [CI], 30-47 months). The 1-, 2-, 3-, 4-, and 5-year cumulative survival rates were 89, 75, 52, 43, and 27%, respectively. From multiple regression analysis, the independent predictors of survival were found to be tumor grading (P=0.002; risk ratio [RR] 0.37, 95% CI 0.20-0.70), bilirubin levels < or =2.5mg/dl (P=0.014; RR 1.58, 95% CI 1.09-2.28), and the achievement of complete tumor ablation (P=0.020; RR 0.53, 95% CI 0.31-0.90). An initial complete tumor ablation was the only factor associated with longer survival in patients with Child-Turcotte-Pugh class A cirrhosis (P=0.012; hazard ratio [HR] 0.48, 95% CI 0.23-1.03). CONCLUSIONS: A complete tumor ablation results in improved survival in all patients with nonsurgical hepatocellular carcinoma. Ideal candidates for PLA are those with a well-differentiated histology, and normal bilirubin levels.
Authors:
Claudio Maurizio Pacella; Giancarlo Bizzarri; Giampiero Francica; Giuseppe Forlini; Alessandra Petrolati; Dario Valle; Vincenzo Anelli; Antonio Bianchini; Stefano De Nuntis; Sara Pacella; Zaccaria Rossi; John Osborn; Roberto Stasi
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-02-28
Journal Detail:
Title:  Journal of hepatology     Volume:  44     ISSN:  0168-8278     ISO Abbreviation:  J. Hepatol.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-04-17     Completed Date:  2006-09-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  902-9     Citation Subset:  IM    
Affiliation:
Department of Diagnostic Imaging and Interventional Radiology, Ospedale Regina Apostolorum, Via San Francesco, 50-00041, Albano Laziale, Rome, Italy. cmpacel@katamail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Bilirubin / blood
Carcinoma, Hepatocellular / mortality*,  pathology,  surgery*
Female
Follow-Up Studies
Humans
Laser Therapy*
Liver Neoplasms / mortality*,  pathology,  surgery*
Male
Middle Aged
Necrosis
Postoperative Complications / mortality
Predictive Value of Tests
Prospective Studies
Regression Analysis
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
635-65-4/Bilirubin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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