INTRODUCTION: Hepatocellular carcinoma (HCC) is a leading cause of death in patients with cirrhosis. Around 12% of all cases are associated with chronic liver disease without cirrhosis. The aim of our study was to compare primary tumor ablation rates, local tumor progression, safety, and long-term outcomes of radiofrequency ablation for single (less than 3.5 cm in diameter) or multiple HCC nodules (up to three nodules, each less than 3 cm) in both types of patients. METHODS: We treated 200 consecutive HCC patients recruited from a local sonographic screening program: 175 with cirrhosis and 25 with non-cirrhotic chronic liver disease. RESULTS: Complete ablation was achieved in 150 of the 175 patients (85.7%) (174 of the 206 nodules treated, 84.4%) in the cirrhotic group and in 24 of the 25 patients (96%) (27 of the 29 nodules treated; 93%) in the non-cirrhotic group. The two groups were not significantly different in terms of local tumor progression rates 1, 3, and 5 years after treatment (11%, 23%, and 24% among cirrhotics vs. 4%, 14%, and 14% among non-cirrhotic patients). Multifocal disease was more frequent among the cirrhotics. One-, three- and five-year survival rates were also similar in the cirrhotic (93%, 77%, and 61%) and non-cirrhotic groups (92%, 72%, and 64%). There were no treatment-related deaths. Severe complications occurred only in the cirrhotic group (2.2%). CONCLUSIONS: Radiofrequency ablation is safe and effective treatment for HCC in patients with or without cirrhosis. The latter group has a significantly lower rate of multifocal disease.
INTRODUCTION: Hepatocellular carcinoma (HCC) is a leading cause of death in patients with cirrhosis. Around 12% of all cases are associated with chronic liver disease without cirrhosis. The aim of our study was to compare primary tumor ablation rates, local tumor progression, safety, and long-term outcomes of radiofrequency ablation for single (less than 3.5 cm in diameter) or multiple HCC nodules (up to three nodules, each less than 3 cm) in both types of patients. METHODS: We treated 200 consecutive HCCpatients recruited from a local sonographic screening program: 175 with cirrhosis and 25 with non-cirrhotic chronic liver disease. RESULTS: Complete ablation was achieved in 150 of the 175 patients (85.7%) (174 of the 206 nodules treated, 84.4%) in the cirrhotic group and in 24 of the 25 patients (96%) (27 of the 29 nodules treated; 93%) in the non-cirrhotic group. The two groups were not significantly different in terms of local tumor progression rates 1, 3, and 5 years after treatment (11%, 23%, and 24% among cirrhotics vs. 4%, 14%, and 14% among non-cirrhotic patients). Multifocal disease was more frequent among the cirrhotics. One-, three- and five-year survival rates were also similar in the cirrhotic (93%, 77%, and 61%) and non-cirrhotic groups (92%, 72%, and 64%). There were no treatment-related deaths. Severe complications occurred only in the cirrhotic group (2.2%). CONCLUSIONS: Radiofrequency ablation is safe and effective treatment for HCC in patients with or without cirrhosis. The latter group has a significantly lower rate of multifocal disease.
Authors: L Bolondi; S Sofia; S Siringo; S Gaiani; A Casali; G Zironi; F Piscaglia; L Gramantieri; M Zanetti; M Sherman Journal: Gut Date: 2001-02 Impact factor: 23.059
Authors: R Chiesa; F Donato; A Tagger; M Favret; M L Ribero; G Nardi; U Gelatti; E Bucella; E Tomasi; N Portolani; M Bonetti; L Bettini; G Pelizzari; A Salmi; A Savio; M Garatti; F Callea Journal: Cancer Epidemiol Biomarkers Prev Date: 2000-02 Impact factor: 4.254
Authors: S Rossi; E Buscarini; F Garbagnati; M Di Stasi; P Quaretti; M Rago; A Zangrandi; S Andreola; D Silverman; L Buscarini Journal: AJR Am J Roentgenol Date: 1998-04 Impact factor: 3.959