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Evaluation of the Effect of Cumulative Operator Experience on Hepatocellular Carcinoma Recurrence after Primary Treatment with Radiofrequency Ablation.

Abstract：

PURPOSE:To investigate the association between cumulative operator volume and the risk of hepatocellular carcinoma (HCC) recurrence after potentially curative radiofrequency ablation (RFA). MATERIALS AND METHODS:This study was approved by the Research Ethics Committee. By using the Taiwan National Health Insurance Research Database, 52 096 patients with HCC were identified between July 1, 2004, and December 31, 2011. In total, 2827 patients were selected who underwent potentially curative RFA for newly diagnosed HCC. These patients were grouped into quintiles according to the cumulative operator volumes. Patients in the lowest or the highest quintiles were 1:1 matched according to their propensity scores. Finally, two separate groups, each containing 406 patients, were recruited in the high- and low-volume groups (cumulative operator volume of ≥79 cases and ≤10 cases, respectively). Cumulative incidences of and hazard ratios for HCC recurrence were analyzed after adjusting for competing mortality. RESULTS:The HCC recurrence rate of the high-volume group was significantly lower than that of the low-volume group (high-volume group 5-year recurrence rate of 65.8%, 95% confidence interval [CI]: 59.5%, 72.1%; low-volume group 5-year recurrence rate of 71.4%, 95% CI: 66.2%, 76.5%; P < .05). In modified Cox regression analysis, the highest cumulative operator volume was independently associated with a decreased risk of HCC recurrence (hazard ratio, 0.80; 95% CI: 0.67, 0.97; P < .05). Multivariable stratified analyses verified the association between the highest cumulative operator volume and decreased HCC recurrence in almost all subgroups. CONCLUSION:The risk of HCC recurrence could be significantly decreased by experienced RFA operators. Further studies based on cumulative operator volume may be helpful in improving the quality of RFA for HCC.

journal_name

Radiology

journal_title

Radiology

authors

Lee TY,Lin JT,Ho HJ,Wu MS,Wu CY

doi

10.1148/radiol.15141864

subject

Has Abstract

pub_date

2015-07-01 00:00:00

pages

294-301

issue

eissn

0033-8419

issn

1527-1315

journal_volume

276

pub_type

杂志文章

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Evaluation of the Effect of Cumulative Operator Experience on Hepatocellular Carcinoma Recurrence after Primary Treatment with Radiofrequency Ablation.