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Long-term outcome of cirrhotic patients with early hepatocellular carcinoma treated with ultrasound-guided percutaneous laser ablation: a retrospective analysis
- Source :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 27(16)
- Publication Year :
- 2009
-
Abstract
- Purpose Percutaneous laser ablation (PLA) has been proposed as an active treatment in patients with hepatocellular carcinoma (HCC). However, large multicenter studies using this technique have not been reported. Patients and Methods We retrospectively analyzed treatment and survival parameters of 432 cirrhotic patients with nonsurgical early HCC (single nodule ≤ 4 cm or three nodules ≤ 3 cm each) who had received PLA in nine Italian centers. Results Single tumors were seen in 344 (80%) of 432 patients, and two to three nodules were seen in 88 patients (20%), for a total of 548 tumors. An initial complete response after PLA was observed in 338 patients (78%). Median overall survival time was 47 months (95% CI, 41 to 53 months). The 3- and 5-year cumulative survival rates were 61% and 34%, respectively. In multivariate analysis, independent predictors of survival were serum albumin levels more than 3.5 g/dL (P = .002; risk ratio [RR] = 0.580; 95% CI, 0.409 to 0.821), the achievement of a complete tumor ablation (P = .001; RR = 0.517; 95% CI, 0.346 to 0.771), and age less than 73 years (P < .001; RR = 0.466; 95% CI, 0.320 to 0.681). Child-Turcotte-Pugh class A patients had a 5-year cumulative survival rate of 41%; this figure increased up to 60% with a median survival time of 63 months (95% CI, 48 to 78 months) in patients with tumors ≤ 2.0 cm. Conclusion This analysis confirms that a complete tumor ablation results in improved survival in patients with nonsurgical HCC. Ideal candidates for PLA are younger patients with normal serum albumin levels and tumor size ≤ 2 cm.
- Subjects :
- Liver Cirrhosis
Male
Cancer Research
medicine.medical_specialty
Percutaneous
Cirrhosis
Carcinoma, Hepatocellular
Time Factors
Kaplan-Meier Estimate
Gastroenterology
Risk Assessment
Disease-Free Survival
Risk Factors
Internal medicine
medicine
Carcinoma
Early Hepatocellular Carcinoma
Humans
Serum Albumin
Ultrasonography, Interventional
Aged
Neoplasm Staging
Proportional Hazards Models
Retrospective Studies
Proportional hazards model
business.industry
Patient Selection
Liver Neoplasms
Age Factors
Retrospective cohort study
Middle Aged
medicine.disease
Surgery
Treatment Outcome
Oncology
Italy
Hepatocellular carcinoma
Female
Laser Therapy
Liver cancer
business
Subjects
Details
- ISSN :
- 15277755
- Volume :
- 27
- Issue :
- 16
- Database :
- OpenAIRE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Accession number :
- edsair.doi.dedup.....10187959aab2ea62d73d5056438400ca