TY - JOUR
T1 - Combined hepatectomy and radiofrequency ablation for multifocal hepatocellular carcinomas
T2 - Long-term follow-up results and prognostic factors
AU - Choi, Dongil
AU - Lim, Hyo K.
AU - Joh, Jae Won
AU - Kim, Sung Joo
AU - Kim, Min Ju
AU - Rhim, Hyunchul
AU - Kim, Young Sun
AU - Yoo, Byung Chul
AU - Paik, Seung Woon
AU - Park, Cheol Keun
N1 - Funding Information:
This study was supported by a grant from the Samsung Medical Center Clinical Research Development Program. We thank Kyong Hee Lee and Kyung Mi Lee at Samsung Biomedical Research Institute for the collection of data, and all members of the Liver Cancer Center of Samsung Medical Center.
PY - 2007/12
Y1 - 2007/12
N2 - Background: For multifocal hepatocellular carcinomas (HCCs) that are untreatable with resection only, locoregional therapies added to hepatectomy have been introduced. However, some preliminary reports have documented average survival results and relatively high complication rates. We evaluated the long-term survival results and safety of combined hepatectomy and radiofrequency ablation (RFA) in patients with HCCs and assessed the prognostic factors affecting their survival. Methods: A total of 53 patients who had 148 HCCs in their livers underwent hepatectomy combined with ultrasound-guided intraoperative RFA. The mean diameter of the 82 resected tumors was 4.8 cm (range 1.3-21.0 cm) and that of 66 ablated tumors was 1.5 cm (range 0.8-3.5 cm). We evaluated the primary effectiveness rates, survival rates, and complications. In addition, we assessed the prognostic factors associated with the survival rates using Cox proportional hazard models. Results: The primary effectiveness rate of RFA was 98% (65 of 66). Local tumor progression was observed in two (3%) ablation zones of 65 tumors with complete primary effectiveness. The cumulative survival rates at 1, 2, 3, 4, and 5 years were 87, 83, 80, 68, and 55%, respectively. Patients with smaller resected tumors (≤5 cm) demonstrated better survival results (P = 0.004). No procedure-related deaths occurred. We observed hepatectomy-related complications in 4 patients (8%, 4 of 53) and an RFA-related complication in 1 patient (2%, 1 of 53). Conclusions: Combined hepatectomy and RFA is an effective and safe treatment modality for multifocal HCCs. Resected tumor size was a significant prognostic predictor of long-term survival.
AB - Background: For multifocal hepatocellular carcinomas (HCCs) that are untreatable with resection only, locoregional therapies added to hepatectomy have been introduced. However, some preliminary reports have documented average survival results and relatively high complication rates. We evaluated the long-term survival results and safety of combined hepatectomy and radiofrequency ablation (RFA) in patients with HCCs and assessed the prognostic factors affecting their survival. Methods: A total of 53 patients who had 148 HCCs in their livers underwent hepatectomy combined with ultrasound-guided intraoperative RFA. The mean diameter of the 82 resected tumors was 4.8 cm (range 1.3-21.0 cm) and that of 66 ablated tumors was 1.5 cm (range 0.8-3.5 cm). We evaluated the primary effectiveness rates, survival rates, and complications. In addition, we assessed the prognostic factors associated with the survival rates using Cox proportional hazard models. Results: The primary effectiveness rate of RFA was 98% (65 of 66). Local tumor progression was observed in two (3%) ablation zones of 65 tumors with complete primary effectiveness. The cumulative survival rates at 1, 2, 3, 4, and 5 years were 87, 83, 80, 68, and 55%, respectively. Patients with smaller resected tumors (≤5 cm) demonstrated better survival results (P = 0.004). No procedure-related deaths occurred. We observed hepatectomy-related complications in 4 patients (8%, 4 of 53) and an RFA-related complication in 1 patient (2%, 1 of 53). Conclusions: Combined hepatectomy and RFA is an effective and safe treatment modality for multifocal HCCs. Resected tumor size was a significant prognostic predictor of long-term survival.
KW - Combined treatment
KW - Hepatectomy
KW - Hepatocellular Carcinoma
KW - Prognostic Factors
KW - Radiofrequency Ablation
KW - Survival
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U2 - 10.1245/s10434-007-9492-7
DO - 10.1245/s10434-007-9492-7
M3 - Article
C2 - 17653800
AN - SCOPUS:36348948472
VL - 14
SP - 3510
EP - 3518
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
SN - 1068-9265
IS - 12
ER -