Combined hepatectomy and radiofrequency ablation for multifocal hepatocellular carcinomas

Long-term follow-up results and prognostic factors

Dongil Choi, Hyo K. Lim, Jae Won Joh, Sung Joo Kim, Min Ju Kim, Hyunchul Rhim, Young Sun Kim, Byung Chul Yoo, Seung Woon Paik, Cheol Keun Park

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)3510-3518
Number of pages9
JournalAnnals of Surgical Oncology
Volume14
Issue number12
DOIs
Publication statusPublished - 2007 Dec 1
Externally publishedYes

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Hepatectomy
Hepatocellular Carcinoma
Survival
Neoplasms
Survival Rate
Proportional Hazards Models
Safety
Liver
Therapeutics

Keywords

  • Combined treatment
  • Hepatectomy
  • Hepatocellular Carcinoma
  • Prognostic Factors
  • Radiofrequency Ablation
  • Survival

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Combined hepatectomy and radiofrequency ablation for multifocal hepatocellular carcinomas : Long-term follow-up results and prognostic factors. / Choi, Dongil; Lim, Hyo K.; Joh, Jae Won; Kim, Sung Joo; Kim, Min Ju; Rhim, Hyunchul; Kim, Young Sun; Yoo, Byung Chul; Paik, Seung Woon; Park, Cheol Keun.

In: Annals of Surgical Oncology, Vol. 14, No. 12, 01.12.2007, p. 3510-3518.

Research output: Contribution to journalArticle

Choi, Dongil ; Lim, Hyo K. ; Joh, Jae Won ; Kim, Sung Joo ; Kim, Min Ju ; Rhim, Hyunchul ; Kim, Young Sun ; Yoo, Byung Chul ; Paik, Seung Woon ; Park, Cheol Keun. / Combined hepatectomy and radiofrequency ablation for multifocal hepatocellular carcinomas : Long-term follow-up results and prognostic factors. In: Annals of Surgical Oncology. 2007 ; Vol. 14, No. 12. pp. 3510-3518.
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abstract = "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.",
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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

PY - 2007/12/1

Y1 - 2007/12/1

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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