Intraoperative radiofrequency ablation for hepatocellular carcinoma in 112 patients with cirrhosis: a surgeon's view
Annals of Surgical Treatment and Research
; : 147-156, 2016.
Article
em En
| WPRIM
| ID: wpr-220407
Biblioteca responsável:
WPRO
ABSTRACT
PURPOSE:
This retrospective study was an investigation of overall survival (OS), disease-free survival (DFS) and prognostic factors affecting OS and DFS in cirrhotic patients who received intraoperative radiofrequency ablation (IORFA).METHODS:
Between April 2009 and November 2013, 112 patients (94 men, 84%; 18 women, 16%) underwent IORFA for 185 cases of hepatocellular carcinomas (HCC). Repeat IORFA was done in 9 patients during the same period (total of 121 treatments).RESULTS:
All patients were followed-up for at least 12 months (mean follow-up, 32 months). Surgical resection combined with IORFA was performed in 20 patients. The technical effectiveness at 1 week was 91.78% (111 of 121). Readmission was 9.1% (11 of 121) and the most common cause was ventral hernia. Procedure-related mortality was 2.7% (3 of 112) and continued fatal biliary leakage was 1.8% (2 of 112). Local recurrence developed in 10 patients (8.9%). Most recurrence was intrahepatic. Cumulative survival was assessed in 33 patients who received IORFA as primary treatment (naive patients) and 79 non-naive patients. The cumulative DFS and OS rate at l and 3 years was 54% and 24%, and 87% and 66%, respectively. Moderate ascites (P = 0.001), tumor located segment I (P = 0.001), portal vein thrombosis (P = 0.001) had poor survival were significant factors by multivariate analysis.CONCLUSION:
IORFA alone or in combination with surgical resection extends the spectrum of liver surgery. A fundamental understanding of RFA, additional comorbidities, and postablation complication are necessary to maximize the safety and efficacy of IORFA for treating HCC with cirrhosis.Palavras-chave
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Índice:
WPRIM
Assunto principal:
Ascite
/
Recidiva
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Fibrose
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Comorbidade
/
Análise Multivariada
/
Estudos Retrospectivos
/
Seguimentos
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Mortalidade
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Ablação por Cateter
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Carcinoma Hepatocelular
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Female
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Humans
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Male
Idioma:
En
Revista:
Annals of Surgical Treatment and Research
Ano de publicação:
2016
Tipo de documento:
Article