Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Division of Gastrointestinal Radiology, Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2019 Jan;82(1):2-10. doi: 10.1097/JCMA.0000000000000001.
To assess long-term prognoses of patients with solitary hepatocellular carcinoma (HCC) < 2 cm (the Barcelona Clinic Liver Cancer, BCLC stage 0) after radiofrequency ablation (RFA).
We retrospectively enrolled 271 patients with BCLC stage 0 HCC who had undergone RFA at Taipei Veterans General Hospital from 2002 to 2016. Factors determining poor overall survival (OS) and recurrence after RFA were analyzed by Cox proportional hazards model.
After a median follow-up duration of 43.4 months, 76 patients had died. The cumulative 5- and 10-year OS rates were 67.1% and 56.4%, respectively. Multivariate analysis disclosed age > 65 years (hazard ratio [HR] 1.608, 95% confidence interval, [CI] 1.015-2.545; p = 0.043), platelet count < 100,000/mm (HR 1.704, 95% CI 1.027-2.828; p = 0.039), and albumin-bilirubin (ALBI) grade 2 or 3 (HR 2.191, 95% CI 1.261-3.805; p = 0.005) were the independent risk factors predicting worse OS. One-hundred twelve patients had tumor recurrence after undergoing RFA. Multivariate analysis showed that ALBI grade 2 or 3 (HR 1.825, 95% CI 1.288-2.585; p = 0.001) was the only one independent risk factor associated with poor recurrence-free survival (RFS) after RFA. Most of the subgroup analyses also demonstrated that patients with ALBI grade 2 or 3 had poorer OS and RFS than those with ALBI grade 1.
For patients with BCLC stage 0 HCC, RFA could provide a long-term outcome with a 10-year overall survival rate of 56.4%. Moreover, the ALBI grade can discriminate prognosis in such patients.
评估巴塞罗那临床肝癌分期（BCLC）0 期、单个肝细胞癌（HCC）<2cm 患者接受射频消融（RFA）治疗后的长期预后。
我们回顾性纳入了 2002 年至 2016 年期间在台北荣民总医院接受 RFA 治疗的 271 例 BCLC 0 期 HCC 患者。采用 Cox 比例风险模型分析影响 RFA 后总体生存（OS）和复发的因素。
中位随访 43.4 个月后，76 例患者死亡。累积 5 年和 10 年 OS 率分别为 67.1%和 56.4%。多变量分析显示年龄>65 岁（风险比 [HR] 1.608，95%置信区间 [CI] 1.015-2.545；p=0.043）、血小板计数<100,000/mm（HR 1.704，95%CI 1.027-2.828；p=0.039）和 ALBI 分级 2 或 3（HR 2.191，95%CI 1.261-3.805；p=0.005）是预测 OS 较差的独立危险因素。112 例患者在接受 RFA 后发生肿瘤复发。多变量分析显示，ALBI 分级 2 或 3（HR 1.825，95%CI 1.288-2.585；p=0.001）是与 RFA 后无复发生存（RFS）较差相关的唯一独立危险因素。大多数亚组分析还表明，ALBI 分级 2 或 3 的患者 OS 和 RFS 均较 ALBI 分级 1 的患者差。
对于 BCLC 0 期 HCC 患者，RFA 可提供长期预后，10 年总生存率为 56.4%。此外，ALBI 分级可区分此类患者的预后。
