Dipartimento Biomedico di Medicina Interna e Specialistica, Sezione di Gastroenterologia, Università di Palermo, Palermo, Italia.
PLoS One. 2013 Jul 29;8(7):e70016. doi: 10.1371/journal.pone.0070016. Print 2013.
Radio-frequency ablation (RFA) has been employed in the treatment of Barcelona Clinic Liver Cancer (BCLC) early stage hepatocellular carcinoma (HCC) as curative treatments.
To assess the effectiveness and the safety of RFA in patients with early HCC and compensated cirrhosis.
A cohort of 151 consecutive patients with early stage HCC (122 Child-Pugh class A and 29 class B patients) treated with RFA were enrolled. Clinical, laboratory and radiological follow-up data were collected from the time of first RFA. A single lesion was observed in 113/151 (74.8%), two lesions in 32/151 (21.2%), and three lesions in 6/151 (4%) of patients.
The overall survival rates were 94%, 80%, 64%, 49%, and 41% at 12, 24, 36, 48 and 60 months, respectively. Complete response (CR) at 1 month (p<0.0001) and serum albumin levels (p = 0.0004) were the only variables indipendently linked to survival by multivariate Cox model. By multivariate analysis, tumor size (p = 0.01) is the only variable associated with an increased likehood of CR. The proportion of major complications after treatment was 4%.
RFA is safe and effective for managing HCC with cirrhosis, especially for patients with HCC ≤3 cm and higher baseline albumin levels. Complete response after RFA significantly increases survival.
射频消融 (RFA) 已被用于治疗巴塞罗那临床肝癌 (BCLC) 早期肝细胞癌 (HCC)，作为一种有治愈可能的治疗方法。
评估 RFA 治疗早期 HCC 和代偿性肝硬化患者的疗效和安全性。
本研究纳入了 151 例接受 RFA 治疗的早期 HCC 患者（122 例 Child-Pugh 分级为 A，29 例为 B 级）。从首次 RFA 开始收集临床、实验室和影像学随访数据。113/151 例（74.8%）患者为单发病变，32/151 例（21.2%）为 2 个病变，6/151 例（4%）为 3 个病变。
总体生存率分别为 12、24、36、48 和 60 个月时的 94%、80%、64%、49%和 41%。1 个月时的完全缓解（CR）（p<0.0001）和血清白蛋白水平（p = 0.0004）是多变量 Cox 模型中唯一与生存相关的独立变量。多变量分析显示，肿瘤大小（p = 0.01）是与 CR 可能性增加相关的唯一变量。治疗后主要并发症的比例为 4%。
RFA 治疗肝硬化合并 HCC 是安全有效的，特别是对于 HCC ≤3cm 和基线白蛋白水平较高的患者。RFA 后获得完全缓解可显著提高生存率。
