Abstract

BACKGROUND: The aim of this study was to evaluate the impact of the interval between diagnosis and treatment using radiofrequency (RF) ablation on the survival of patients with HCC detected through a surveillance program.

METHODS: Between January 2004 and July 2007, 121 cirrhotic patients with 157 tumours detected through a surveillance program underwent RF ablation. A delay in treatment was defined as >5 weeks. The mean length of follow-up was 25 months (range 8-55 months). Cumulative survival of patients was analysed using the Kaplan-Meier method. Cox regression models were used to identify factors associated with patient survival.

RESULTS: The 1-, 2- and 3-year survival rates were 92.5%, 78.5% and 67.2%. The independent predictors of poorer patient survival were time from diagnosis to treatment >5 weeks (pooled odds ratio [OR], 3.59; 95% confidence interval [CI], 1.58-8.18; P=0.002), absence of complete ablation after the initial RF session (OR, 2.42; 95% CI 1.07-5.45; P=0.033) and Child-Pugh B liver cirrhosis (OR, 2.46; 95% CI 1.06-5.70; P=0.036).

CONCLUSIONS: Delay in the start of effective treatment for HCC using RF ablation may be associated with poorer patient survival.