| The Limitation of Repeated Radiofrequency Ablation in Hepatocellular Carcinoma: Proposal of a 3 (times)-3 (years)-INDEX. | |
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MedLine Citation:
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PMID: 22433056 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background and Aim: Percutaneous radiofrequency ablation (RFA) has been shown to be a highly effective treatment for hepatocellular carcinoma (HCC). We investigated the controllability of HCC and explored the algorithm of therapeutic strategy for HCC met the RFA criteria. Methods: We enrolled 472 patients with HCC who met the RFA criteria (< 3 nodules, < 3 cm) and underwent RFA for initial therapy. Patients who underwent repeated RFA were evaluated retrospectively when HCC exceeded the RFA criteria or the functional hepatic reserve progressed to Child-Pugh grade C. Results: Overall survival rates were: 1 year, 96%; 3 years, 79%; and 5 years, 56%. In 5 years, 14% of patients progressed to Child-Pugh grade C. Meanwhile, 47% of patients exceeded the RFA criteria. Annually, 8% of patients deviated from the RFA criteria. The percentage of patients who were able to receive RFA significantly decreased at the fourth session compared with up to the third session. The survival rates decreased at the rate of 7% annually until the third year after the initial RFA. Afterwards, it shifted to the decrease at the rate of 12% annually. In multivariate analysis, the presence of HCV infection and the existence of a single tumor were identified as significant independent factors contributing to probabilities exceeding the RFA criteria. Conclusions: HCC was controlled by RFA up to three RFA treatments and three years from the initial therapy. On this basis, we propose a "3 (times)-3 (years)-INDEX" for considering a shift from RFA to other treatment modalities. © 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd. |
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Authors:
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Keiji Yokoyama; Akira Anan; Kaoru Iwata; Shinya Nishizawa; Daisuke Morihara; Shu-Ichi Ueda; Kunitoshi Sakurai; Hideyuki Iwashita; Genryu Hirano; Masaharu Sakamoto; Yasuaki Takeyama; Makoto Irie; Satoshi Shakado; Tetsuro Sohda; Shotaro Sakisaka |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-3-20 |
Journal Detail:
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Title: Journal of gastroenterology and hepatology Volume: - ISSN: 1440-1746 ISO Abbreviation: - Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-3-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8607909 Medline TA: J Gastroenterol Hepatol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd. |
Affiliation:
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Department of Gastroenterology, Fukuoka University Faculty of Medicine, Fukuoka, Japan. The Division of Advanced Clinical Research for Viral Hepatitis and Liver Cancer, Fukuoka University Faculty of Medicine, Fukuoka, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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