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Article: Analysis of recurrence pattern and its influence on survival outcome after radiofrequency ablation of hepatocellular carcinoma

TitleAnalysis of recurrence pattern and its influence on survival outcome after radiofrequency ablation of hepatocellular carcinoma
Authors
KeywordsAblation
Carcinoma
Hepatocellular
Pattern
Radiofrequency
Recurrence
Issue Date2008
PublisherSpringer New York LLC.
Citation
Journal Of Gastrointestinal Surgery, 2008, v. 12 n. 1, p. 183-191 How to Cite?
AbstractRadiofrequency ablation (RFA) is an effective local ablation therapy for hepatocellular carcinoma (HCC) with favorable long-term outcome. There is no data on the analysis of recurrence pattern and its influence on long-term survival outcome after RFA in HCC patients. To evaluate the tumor recurrence pattern and its influence on long-term survival in patients with HCC treated with RFA. From April 2001 to January 2005, 209 patients received RFA using internally cooled electrode as the sole treatment modality for HCC. Among them, 117 patients (56%) had unresectable HCC because of bilobar disease, poor liver function, and/or high medical risk for resection; whereas 92 patients (44%) underwent RFA as the primary treatment for small resectable HCC. The ablation procedure was performed through percutaneous (n∈=∈101), laparoscopic (n∈=∈17), or open approaches (n∈=∈91). The tumor recurrence pattern and long-term survival were analyzed. Multivariate analysis was carried out to identify independent prognostic factors affecting the overall survival of patients. The mortality and morbidity rates were 0.9 and 15.7%, respectively. Complete tumor ablation was achieved in 192 patients (92.7%). With a median follow-up period of 26 months, local recurrence occurred in 28 patients (14.5%). Same segment and different segment intrahepatic recurrence occurred in 30 patients (15.6%) and 78 patients (40.6%), respectively. Twenty patients (10.4%) developed distant extrahepatic metastases. The overall 1-, 3-, and 5-year survival rates were 87.2, 66.6, and 42%, respectively. Different segment intrahepatic recurrence and distant recurrence after RFA carried significant poor prognostic influence on overall survival outcome. Using multivariate analysis, Child-Pugh grade (risk ratio [RR]∈=∈2.918, 95% confident interval [CI] 1.704-4.998, p∈=∈0.000), tumor size (RR∈=∈1. 231, 95% CI 1.031-1.469, p∈=∈0.021), and pattern of recurrence (risk ratio [RR]∈=∈1.464, 95% CI 1.156-1.987, P∈=∈0.020) were identified as independent prognostic factors for overall survival. The tumor recurrence pattern after RFA carries significant prognostic value in relation to overall survival. Long-term regular surveillance and aggressive treatment strategy are required for patients with different segment intrahepatic recurrence to optimize the benefits of RFA. © 2007 The Society for Surgery of the Alimentary Tract.
Persistent Identifierhttp://hdl.handle.net/10722/83835
ISSN
2015 Impact Factor: 2.807
2015 SCImago Journal Rankings: 1.640
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorNg, KKen_HK
dc.contributor.authorPoon, RTen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorYuen, Jen_HK
dc.contributor.authorTso, WKen_HK
dc.contributor.authorFan, STen_HK
dc.date.accessioned2010-09-06T08:45:48Z-
dc.date.available2010-09-06T08:45:48Z-
dc.date.issued2008en_HK
dc.identifier.citationJournal Of Gastrointestinal Surgery, 2008, v. 12 n. 1, p. 183-191en_HK
dc.identifier.issn1091-255Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/83835-
dc.description.abstractRadiofrequency ablation (RFA) is an effective local ablation therapy for hepatocellular carcinoma (HCC) with favorable long-term outcome. There is no data on the analysis of recurrence pattern and its influence on long-term survival outcome after RFA in HCC patients. To evaluate the tumor recurrence pattern and its influence on long-term survival in patients with HCC treated with RFA. From April 2001 to January 2005, 209 patients received RFA using internally cooled electrode as the sole treatment modality for HCC. Among them, 117 patients (56%) had unresectable HCC because of bilobar disease, poor liver function, and/or high medical risk for resection; whereas 92 patients (44%) underwent RFA as the primary treatment for small resectable HCC. The ablation procedure was performed through percutaneous (n∈=∈101), laparoscopic (n∈=∈17), or open approaches (n∈=∈91). The tumor recurrence pattern and long-term survival were analyzed. Multivariate analysis was carried out to identify independent prognostic factors affecting the overall survival of patients. The mortality and morbidity rates were 0.9 and 15.7%, respectively. Complete tumor ablation was achieved in 192 patients (92.7%). With a median follow-up period of 26 months, local recurrence occurred in 28 patients (14.5%). Same segment and different segment intrahepatic recurrence occurred in 30 patients (15.6%) and 78 patients (40.6%), respectively. Twenty patients (10.4%) developed distant extrahepatic metastases. The overall 1-, 3-, and 5-year survival rates were 87.2, 66.6, and 42%, respectively. Different segment intrahepatic recurrence and distant recurrence after RFA carried significant poor prognostic influence on overall survival outcome. Using multivariate analysis, Child-Pugh grade (risk ratio [RR]∈=∈2.918, 95% confident interval [CI] 1.704-4.998, p∈=∈0.000), tumor size (RR∈=∈1. 231, 95% CI 1.031-1.469, p∈=∈0.021), and pattern of recurrence (risk ratio [RR]∈=∈1.464, 95% CI 1.156-1.987, P∈=∈0.020) were identified as independent prognostic factors for overall survival. The tumor recurrence pattern after RFA carries significant prognostic value in relation to overall survival. Long-term regular surveillance and aggressive treatment strategy are required for patients with different segment intrahepatic recurrence to optimize the benefits of RFA. © 2007 The Society for Surgery of the Alimentary Tract.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC.en_HK
dc.relation.ispartofJournal of Gastrointestinal Surgeryen_HK
dc.subjectAblationen_HK
dc.subjectCarcinomaen_HK
dc.subjectHepatocellularen_HK
dc.subjectPatternen_HK
dc.subjectRadiofrequencyen_HK
dc.subjectRecurrenceen_HK
dc.titleAnalysis of recurrence pattern and its influence on survival outcome after radiofrequency ablation of hepatocellular carcinomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1091-255X&volume=12&issue=1&spage=183&epage=191&date=2008&atitle=Analysis+of+recurrence+pattern+and+its+influence+on+survival+outcome+after+radiofrequency+ablation+of+hepatocellular+carcinomaen_HK
dc.identifier.emailPoon, RT: poontp@hkucc.hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityPoon, RT=rp00446en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s11605-007-0276-yen_HK
dc.identifier.pmid17874276-
dc.identifier.scopuseid_2-s2.0-38149091762en_HK
dc.identifier.hkuros140974en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-38149091762&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume12en_HK
dc.identifier.issue1en_HK
dc.identifier.spage183en_HK
dc.identifier.epage191en_HK
dc.identifier.isiWOS:000252297100029-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridNg, KK=7403179075en_HK
dc.identifier.scopusauthoridPoon, RT=7103097223en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridYuen, J=7102620431en_HK
dc.identifier.scopusauthoridTso, WK=7006905486en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.citeulike1675678-

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