| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Vascular and Interventional Radiology |
1 From the Division of Diagnostic and Interventional Radiology, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Via Roma 67, I-56125 Pisa, Italy. From the 2003 RSNA Annual Meeting. Received February 23, 2004; revision requested May 3; revision received July 2; accepted August 4. Address correspondence to R.L. (e-mail: lencioni@do.med.unipi.it).
PURPOSE: To perform a prospective, intention-to-treat clinical trial to determine the long-term survival rates of patients with hepatic cirrhosis and early-stage hepatocellular carcinoma (HCC) in whom percutaneous image-guided radiofrequency (RF) ablation was used as the sole first-line anticancer treatment.
MATERIALS AND METHODS: The study was performed with approval of the ethics committee, and written informed consent was obtained for all patients. From June 1, 1996, to January 1, 2003, 206 patients (143 men, 63 women; age range, 51–81 years; mean age, 67 years ± 7) who were excluded from surgery and who had Child class A or B cirrhosis with either a single HCC less than or equal to 5 cm in diameter or multiple (as many as three) HCCs less than or equal to 3 cm in diameter each were enrolled. RF ablation was performed in 187 (91%) of 206 patients; 19 (9%) were excluded from RF treatment because of unfavorable tumor location. Follow-up ranged from 3 to 78 months (mean, 24 months ± 21) and included measurement of 
-fetoprotein level, ultrasonography at 3-month intervals, and spiral computed tomography at 6-month intervals. Patients were observed for recurrence of the treated tumor and for the emergence of new HCC tumors. Survival probabilities were estimated with the Kaplan-Meier method, and differences between survival curves were evaluated with the log-rank test.
RESULTS: At the end of the study, 145 patients were alive, and 61 were dead. In the intention-to-treat analysis, overall survival rates were 97% at 1 year, 67% at 3 years, and 41% at 5 years. Median survival was 49 months. In the 187 patients treated with RF ablation, overall survival rates were 97% at 1 year, 71% at 3 years, and 48% at 5 years. Median survival was 57 months. The difference between the two survival curves was not statistically significant (P = .5094). Survival of patients treated with RF ablation was dependent on Child class (P = .0006) and tumor multiplicity (P = .0133). Patients who had Child class A cirrhosis with solitary HCC (n = 116) had 1-, 3-, and 5-year survival rates of 100%, 89% and 61%; median survival was 65 months. The 1-, 3-, and 5-year recurrence rates were 14%, 49%, and 81% for the emergence of new tumors and 4%, 10%, and 10% for local tumor progression.
CONCLUSION: RF ablation is an effective first-line treatment for cirrhotic patients with early-stage HCC who were excluded from surgery.
© RSNA, 2005
This article has been cited by other articles:
|
|
 |
|
  K. E. Corey and D. S. Pratt Review: Current status of therapy for hepatocellular carcinoma Therapeutic Advances in Gastroenterology, January 1, 2009; 2(1): 45 - 57. [Abstract] [PDF]
|
|
|
|
 |
|
 Y.-s. Kim, H. Rhim, H. K. Lim, D. Choi, W. J. Lee, T. Y. Jeon, J. W. Joh, and S. J. Kim Intraoperative Radiofrequency Ablation for Hepatocellular Carcinoma: Long-Term Results in a Large Series Ann. Surg. Oncol., July 1, 2008; 15(7): 1862 - 1870. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Park, D. Choi, H. K. Lim, H. Rhim, Y.-s. Kim, S. H. Kim, and W. J. Lee Growth Rate of New Hepatocellular Carcinoma After Percutaneous Radiofrequency Ablation: Evaluation with Multiphase CT Am. J. Roentgenol., July 1, 2008; 191(1): 215 - 220. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Seror, G. N'Kontchou, M. Ibraheem, Y. Ajavon, C. Barrucand, N. Ganne, E. Coderc, J. Claude Trinchet, M. Beaugrand, and N. Sellier Large (>=5.0-cm) HCCs: Multipolar RF Ablation with Three Internally Cooled Bipolar Electrodes--Initial Experience in 26 Patients Radiology, July 1, 2008; 248(1): 288 - 296. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. K. Kei, H. Rhim, D. Choi, W. J. Lee, H. K. Lim, and Y.-s. Kim Local Tumor Progression After Radiofrequency Ablation of Liver Tumors: Analysis of Morphologic Pattern and Site of Recurrence Am. J. Roentgenol., June 1, 2008; 190(6): 1544 - 1551. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Rhim, M. H. Lee, Y.-s. Kim, D. Choi, W. J. Lee, and H. K. Lim Planning Sonography to Assess the Feasibility of Percutaneous Radiofrequency Ablation of Hepatocellular Carcinomas Am. J. Roentgenol., May 1, 2008; 190(5): 1324 - 1330. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Belghiti, B. I. Carr, P. D. Greig, R. Lencioni, and R. T. Poon Treatment before Liver Transplantation for HCC Ann. Surg. Oncol., April 1, 2008; 15(4): 993 - 1000. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. B. Brown, W. C. Chapman, R. D. Cook, J. R. Kerr, J. E. Gould, T. K. Pilgram, and M. D. Darcy Chemoembolization of Hepatocellular Carcinoma: Patient Status at Presentation and Outcome over 15 Years at a Single Center Am. J. Roentgenol., March 1, 2008; 190(3): 608 - 615. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. N. Wong, C.-J. Lin, C.-C. Lin, W.-T. Chen, I. H. Y. Cua, and S.-M. Lin Combined Percutaneous Radiofrequency Ablation and Ethanol Injection for Hepatocellular Carcinoma in High-Risk Locations Am. J. Roentgenol., March 1, 2008; 190(3): W187 - W195. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.-h. Park, H. Rhim, Y.-s. Kim, D. Choi, H. K. Lim, and W. J. Lee Spectrum of CT Findings after Radiofrequency Ablation of Hepatic Tumors RadioGraphics, March 1, 2008; 28(2): 379 - 390. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Rhim, H. K. Lim, Y.-s. Kim, and D. Choi Percutaneous Radiofrequency Ablation with Artificial Ascites for Hepatocellular Carcinoma in the Hepatic Dome: Initial Experience Am. J. Roentgenol., January 1, 2008; 190(1): 91 - 98. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Choi, H. K. Lim, J.-W. Joh, S.-J. Kim, M. J. Kim, H. Rhim, Y.-s. Kim, B. C. Yoo, S. W. Paik, and C. K. Park Combined Hepatectomy and Radiofrequency Ablation for Multifocal Hepatocellular Carcinomas: Long-term Follow-up Results and Prognostic Factors Ann. Surg. Oncol., December 1, 2007; 14(12): 3510 - 3518. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. M. Vogt, G. Antoch, P. Veit, L. S. Freudenberg, N. Blechschmid, O. Diersch, A. Bockisch, J. Barkhausen, and H. Kuehl Morphologic and Functional Changes in Nontumorous Liver Tissue After Radiofrequency Ablation in an In Vivo Model: Comparison of 18F-FDG PET/CT, MRI, Ultrasound, and CT J. Nucl. Med., November 1, 2007; 48(11): 1836 - 1844. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Choi, H. K. Lim, H. Rhim, Y.-s. Kim, B. C. Yoo, S. W. Paik, J.-W. Joh, and C. K. Park Percutaneous Radiofrequency Ablation for Recurrent Hepatocellular Carcinoma After Hepatectomy: Long-term Results and Prognostic Factors Ann. Surg. Oncol., August 1, 2007; 14(8): 2319 - 2329. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Hakime, A. Hines-Peralta, H. Peddi, M. B. Atkins, V. P. Sukhatme, S. Signoretti, M. Regan, and S. N. Goldberg Combination of Radiofrequency Ablation with Antiangiogenic Therapy for Tumor Ablation Efficacy: Study in Mice Radiology, August 1, 2007; 244(2): 464 - 470. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. T. P. Poon, C. Lau, R. Pang, K. K. Ng, J. Yuen, and S. T. Fan High Serum Vascular Endothelial Growth Factor Levels Predict Poor Prognosis after Radiofrequency Ablation of Hepatocellular Carcinoma: Importance of Tumor Biomarker in Ablative Therapies Ann. Surg. Oncol., June 1, 2007; 14(6): 1835 - 1845. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. F. Laeseke, T. M. Frey, C. L. Brace, L. A. Sampson, T. C. Winter III, J. R. Ketzler, and F. T. Lee Jr. Multiple-Electrode Radiofrequency Ablation of Hepatic Malignancies: Initial Clinical Experience Am. J. Roentgenol., June 1, 2007; 188(6): 1485 - 1494. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S.-Y. Chiou, J.-B. Liu, and L. Needleman Current Status of Sonographically Guided Radiofrequency Ablation Techniques J. Ultrasound Med., April 1, 2007; 26(4): 487 - 499. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Liapi and J.-F. H. Geschwind Transcatheter and Ablative Therapeutic Approaches for Solid Malignancies J. Clin. Oncol., March 10, 2007; 25(8): 978 - 986. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. J. Simon, D. E. Dupuy, D. A. Iannitti, D. S. K. Lu, N. C. Yu, B. I. Aswad, R. W. Busuttil, and C. Lassman Intraoperative Triple Antenna Hepatic Microwave Ablation Am. J. Roentgenol., October 1, 2006; 187(4): W333 - W340. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Hines-Peralta, V. Sukhatme, M. Regan, S. Signoretti, Z.-j. Liu, and S. N. Goldberg Improved Tumor Destruction with Arsenic Trioxide and Radiofrequency Ablation in Three Animal Models Radiology, July 1, 2006; 240(1): 82 - 89. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Higgins and D. L. Berger RFA for Liver Tumors: Does It Really Work? Oncologist, July 1, 2006; 11(7): 801 - 808. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. U. Hines-Peralta, N. Pirani, P. Clegg, N. Cronin, T. P. Ryan, Z. Liu, and S. N. Goldberg Microwave Ablation: Results with a 2.45-GHz Applicator in ex Vivo Bovine and in Vivo Porcine Liver Radiology, April 1, 2006; 239(1): 94 - 102. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Belghiti and V. Vilgrain Radiofrequency Ablation of Hepatocellular Carcinoma: Who Should Do It ? Ann. Surg. Oncol., August 1, 2005; 12(8): 579 - 580. [Full Text] [PDF]
|
|
|
|
 |
|
 J. F. Wilson Liver Cancer on the Rise Ann Intern Med, June 21, 2005; 142(12_Part_1): 1029 - 1032. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| RADIOLOGY | RADIOGRAPHICS | RSNA JOURNALS ONLINE |
