Radiofrequency ablation following first-line transarterial chemoembolization for patients with unresectable hepatocellular carcinoma beyond the Milan criteria

BMC Gastroenterology

Zheng-gang Ren¹  Sheng-long Ye¹  Yan-hong Wang¹  Ning-lin Ge¹  Xiao-ying Xie¹  Yi Chen¹  Ju-bo Zhang¹  Bo-heng Zhang¹  Yu-hong Gan¹  Xin Yin¹  Lan Zhang¹ 

[1]Key Laboratory of Carcinogenesis and Cancer Invasion (Fudan University), Ministry of Education, 136 Xue Yuan Road, Shanghai 200032, China

关键词: Milan criteria;    Transcatheter arterial chemoembolization;    Radiofrequency ablation;    Hepatocellular carcinoma;   

Others  :  856705
DOI  :  10.1186/1471-230X-14-11

 received in 2013-05-09, accepted in 2014-01-03,  发布年份 2014

【 摘 要 】

Background

Recent studies suggest that a combination of radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) may have theoretical advantages over TACE alone for treatment of hepatocellular carcinoma (HCC). The purpose of this study was to evaluate the effectiveness and safety of radiofrequency ablation following first-line TACE treatment in the management of HCC beyond the Milan Criteria.

Methods

Forty-five patients who consecutively underwent RFA following first-line TACE treatment for HCC beyond the Milan criteria were enrolled in this study. RFA was performed within 1–2 months after TACE treatment in patients who had incomplete necrotic tumor nodules. Primary effectiveness, complications, survival rates, and prognostic factors were evaluated retrospectively.

Results

Complete ablation was achieved in 76.2% of the lesions according to 1-month follow-up computed tomography/magnetic resonance imaging evaluation. The mean follow-up period was 30.9 months (range 3–94 months). There were no major complications after RFA therapy. The median overall survival was 29 months (range 20–38 months), with 1-, 2-, and 3-year survival of 89%, 61%, and 43%, respectively. Multivariate analysis revealed that tumor diameter (P = 0.045, hazard ratio [HR] = 0.228, 95% confidence interval [CI]: 0.054-0.968) and pretreatment serum alpha-fetoprotein level (P = 0.024, HR = 2.239, 95% CI: 1.114-4.500) were independent predictors for long-term survival.

Conclusions

HCC beyond the Milan criteria can be completely and safely ablated by radiofrequency ablation following first-line TACE treatment with a low rate of complications and favorable survival outcome. Further assessment of the survival benefits of combination treatment for HCCs beyond the Milan Criteria is warranted.

【 授权许可】

   
2014 zhang et al.; licensee BioMed Central Ltd.

【 图 表 】

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