E Berber1, S Rogers, A Siperstein. 1. Department of General Surgery, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Abstract
BACKGROUND: Most patients with hepatocellular carcinoma (HCC) are not candidates for hepatic resection or liver transplantation. Radiofrequency ablation (RFA) provides local control for unresectable HCC with minimal morbidity. The aim of this prospective study is to determine factors predicting survival in patients with HCC undergoing RFA. METHODS: Sixty-six consecutive patients with HCC who were not candidates for a curative liver resection and were free of extrahepatic disease underwent laparoscopic RFA. The relationship between demographic, clinical, laboratory, and surgical parameters and survival was assessed using univariate Kaplan-Meier survival and multivariate Cox proportional hazards model. RESULTS: The median Kaplan-Meier survival for all patients was 25.3 months after RFA. Although alfa fetal protein (AFP), bilirubin, ascites, and Child class were statistically significant predictors of survival by univariate analysis, only the Child class and AFP were independent predictors by multivariate analysis. CONCLUSIONS: This study determines which patients do best after RFA and shows that RFA can provide significant survival for patients with unresectable HCC while also forming a bridge to liver transplantation. RFA has become the first line of treatment in the management of these patients.
BACKGROUND: Most patients with hepatocellular carcinoma (HCC) are not candidates for hepatic resection or liver transplantation. Radiofrequency ablation (RFA) provides local control for unresectable HCC with minimal morbidity. The aim of this prospective study is to determine factors predicting survival in patients with HCC undergoing RFA. METHODS: Sixty-six consecutive patients with HCC who were not candidates for a curative liver resection and were free of extrahepatic disease underwent laparoscopic RFA. The relationship between demographic, clinical, laboratory, and surgical parameters and survival was assessed using univariate Kaplan-Meier survival and multivariate Cox proportional hazards model. RESULTS: The median Kaplan-Meier survival for all patients was 25.3 months after RFA. Although alfa fetal protein (AFP), bilirubin, ascites, and Child class were statistically significant predictors of survival by univariate analysis, only the Child class and AFP were independent predictors by multivariate analysis. CONCLUSIONS: This study determines which patients do best after RFA and shows that RFA can provide significant survival for patients with unresectable HCC while also forming a bridge to liver transplantation. RFA has become the first line of treatment in the management of these patients.
Authors: T Livraghi; A Giorgio; G Marin; A Salmi; I de Sio; L Bolondi; M Pompili; F Brunello; S Lazzaroni; G Torzilli Journal: Radiology Date: 1995-10 Impact factor: 11.105
Authors: Eren Berber; Michael Tsinberg; Gurkan Tellioglu; Conrad H Simpfendorfer; Allan E Siperstein Journal: J Gastrointest Surg Date: 2008-08-08 Impact factor: 3.452
Authors: Orhan Agcaoglu; Shamil Aliyev; Koray Karabulut; Galal El-Gazzaz; Federico Aucejo; Robert Pelley; Allan E Siperstein; Eren Berber Journal: World J Surg Date: 2013-06 Impact factor: 3.352