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Article: Learning Curve for Radiofrequency Ablation of Liver Tumors: Prospective Analysis of Initial 100 Patients in a Tertiary Institution

TitleLearning Curve for Radiofrequency Ablation of Liver Tumors: Prospective Analysis of Initial 100 Patients in a Tertiary Institution
Authors
Issue Date2004
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals Of Surgery, 2004, v. 239 n. 4, p. 441-449 How to Cite?
AbstractObjective: This study aims to evaluate the effect of operator experience on the treatment outcomes of radiofrequency ablation (RFA) for malignant liver tumors. Summary Background Data: RFA is gaining popularity as the ablative therapy of choice for liver tumors. It is generally considered a simple and safe technique, and little attention has been paid to the importance of operator experience in this treatment. A learning curve in this treatment modality has not been documented before. Patients and Methods: The clinical data and treatment outcomes of the initial 100 patients undergoing RFA for liver tumors (hepatocellular carcinoma, n = 84; metastasis, n = 15; cholangiocarcinoma n = 1) were collected prospectively. All patients were managed by a single team of surgeons and interventional radiologists. The data of the first 50 patients (group I) and the second 50 patients (group II) were compared. Results: RFA was performed by percutaneous (group I, n = 22; group II, n = 19), open (group I, n = 26; group II, n = 30) or laparoscopic (group I, n = 2; group II, n = 1) approach. In group I, 30 patients (60%) had a solitary tumor and 20 (40%) had multiple tumors; in group II, 35 patients (70%) had a solitary tumor and 15 (30%) had multiple tumors (P = 0.295). The size of the largest tumor was comparable between groups I and II (median, 2.8 cm in both groups; P = 0.508). Group II had significantly shorter hospital stay (median, 4.0 versus 5.5 days; P = 0.048), lower morbidity rate (4% versus 16%; P = 0.046) and higher complete ablation rate (100% versus 85.7%; P = 0.006) than group I. There was 1 hospital death (2%) in group I and 0 in group II. By multivariate analysis, treatment period (group I versus group II) was an independent significant factor affecting the morbidity rate and complete ablation rate. Conclusions: A low complication rate and a high complete ablation rate could be achieved with the accumulated experience from the first 50 cases of RFA for liver tumors by a specialized team. This study demonstrates that there is a significant learning curve in RFA for liver tumors.
Persistent Identifierhttp://hdl.handle.net/10722/49026
ISSN
2015 Impact Factor: 8.569
2015 SCImago Journal Rankings: 4.503
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorPoon, RTen_HK
dc.contributor.authorNg, KKen_HK
dc.contributor.authorLam, CMen_HK
dc.contributor.authorAi, Ven_HK
dc.contributor.authorYuen, Jen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2008-06-12T06:32:33Z-
dc.date.available2008-06-12T06:32:33Z-
dc.date.issued2004en_HK
dc.identifier.citationAnnals Of Surgery, 2004, v. 239 n. 4, p. 441-449en_HK
dc.identifier.issn0003-4932en_HK
dc.identifier.urihttp://hdl.handle.net/10722/49026-
dc.description.abstractObjective: This study aims to evaluate the effect of operator experience on the treatment outcomes of radiofrequency ablation (RFA) for malignant liver tumors. Summary Background Data: RFA is gaining popularity as the ablative therapy of choice for liver tumors. It is generally considered a simple and safe technique, and little attention has been paid to the importance of operator experience in this treatment. A learning curve in this treatment modality has not been documented before. Patients and Methods: The clinical data and treatment outcomes of the initial 100 patients undergoing RFA for liver tumors (hepatocellular carcinoma, n = 84; metastasis, n = 15; cholangiocarcinoma n = 1) were collected prospectively. All patients were managed by a single team of surgeons and interventional radiologists. The data of the first 50 patients (group I) and the second 50 patients (group II) were compared. Results: RFA was performed by percutaneous (group I, n = 22; group II, n = 19), open (group I, n = 26; group II, n = 30) or laparoscopic (group I, n = 2; group II, n = 1) approach. In group I, 30 patients (60%) had a solitary tumor and 20 (40%) had multiple tumors; in group II, 35 patients (70%) had a solitary tumor and 15 (30%) had multiple tumors (P = 0.295). The size of the largest tumor was comparable between groups I and II (median, 2.8 cm in both groups; P = 0.508). Group II had significantly shorter hospital stay (median, 4.0 versus 5.5 days; P = 0.048), lower morbidity rate (4% versus 16%; P = 0.046) and higher complete ablation rate (100% versus 85.7%; P = 0.006) than group I. There was 1 hospital death (2%) in group I and 0 in group II. By multivariate analysis, treatment period (group I versus group II) was an independent significant factor affecting the morbidity rate and complete ablation rate. Conclusions: A low complication rate and a high complete ablation rate could be achieved with the accumulated experience from the first 50 cases of RFA for liver tumors by a specialized team. This study demonstrates that there is a significant learning curve in RFA for liver tumors.en_HK
dc.format.extent388 bytes-
dc.format.mimetypetext/html-
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.comen_HK
dc.relation.ispartofAnnals of Surgeryen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshCatheter Ablation - standards - statistics & numerical dataen_HK
dc.subject.meshClinical Competence - standards - statistics & numerical dataen_HK
dc.subject.meshLiver Neoplasms - secondary - therapyen_HK
dc.subject.meshCarcinoma, Hepatocellular - therapyen_HK
dc.subject.meshCholangiocarcinoma - therapyen_HK
dc.titleLearning Curve for Radiofrequency Ablation of Liver Tumors: Prospective Analysis of Initial 100 Patients in a Tertiary Institutionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-4932&volume=239&issue=4&spage=441&epage=449&date=2004&atitle=Learning+curve+for+radiofrequency+ablation+of+liver+tumors:+prospective+analysis+of+initial+100+patients+in+a+tertiary+institutionen_HK
dc.identifier.emailPoon, RT: poontp@hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityPoon, RT=rp00446en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1097/01.sla.0000118565.21298.0aen_HK
dc.identifier.pmid15024304-
dc.identifier.pmcidPMC1356248en_HK
dc.identifier.scopuseid_2-s2.0-1642268463en_HK
dc.identifier.hkuros85939-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-1642268463&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume239en_HK
dc.identifier.issue4en_HK
dc.identifier.spage441en_HK
dc.identifier.epage449en_HK
dc.identifier.isiWOS:000220382400003-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridPoon, RT=7103097223en_HK
dc.identifier.scopusauthoridNg, KK=35248894000en_HK
dc.identifier.scopusauthoridLam, CM=36799183200en_HK
dc.identifier.scopusauthoridAi, V=6603342063en_HK
dc.identifier.scopusauthoridYuen, J=7102620431en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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