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Analysis of factors predicting survival in patients with hepatocellular carcinoma treated with percutaneous laser ablation.

Abstract：

BACKGROUND/AIMS:The factors which predict the long-term outcome in patients with hepatocellular carcinoma who are treated with percutaneous laser ablation (PLA) are not well established. METHODS:We prospectively analyzed treatment and survival parameters of 148 cirrhotic patients with nonsurgical hepatocellular carcinoma who had undergone PLA at a single institution during an 11-year period. RESULTS:Single tumors were seen in 129 of 148 (87%) patients, and 2-3 nodules were seen in 19 (13%) patients, for a total of 169 tumors. The median overall time survival was 39 months (95% confidence interval [CI], 30-47 months). The 1-, 2-, 3-, 4-, and 5-year cumulative survival rates were 89, 75, 52, 43, and 27%, respectively. From multiple regression analysis, the independent predictors of survival were found to be tumor grading (P=0.002; risk ratio [RR] 0.37, 95% CI 0.20-0.70), bilirubin levels < or =2.5mg/dl (P=0.014; RR 1.58, 95% CI 1.09-2.28), and the achievement of complete tumor ablation (P=0.020; RR 0.53, 95% CI 0.31-0.90). An initial complete tumor ablation was the only factor associated with longer survival in patients with Child-Turcotte-Pugh class A cirrhosis (P=0.012; hazard ratio [HR] 0.48, 95% CI 0.23-1.03). CONCLUSIONS:A complete tumor ablation results in improved survival in all patients with nonsurgical hepatocellular carcinoma. Ideal candidates for PLA are those with a well-differentiated histology, and normal bilirubin levels.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

Pacella CM,Bizzarri G,Francica G,Forlini G,Petrolati A,Valle D,Anelli V,Bianchini A,Nuntis SD,Pacella S,Rossi Z,Osborn J,Stasi R

doi

10.1016/j.jhep.2006.01.031

subject

Has Abstract

pub_date

2006-05-01 00:00:00

pages

902-9

issue

5

eissn

0168-8278

issn

1600-0641

pii

S0168-8278(06)00084-5

journal_volume

44

pub_type

临床试验,杂志文章

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