CLDF Title
Home | Contact Us | Bookmark
HBV HE HCC HCV
About CLDF Centers of Educational Expertise  
CME Dinner Meetings Telewebs Webcasts Slide Library Abstract Library Conference Highlights
 
Back  
 
Reuters Health Information (2011-12-21): Long-term survival possible with radiofrequency ablation of liver tumors

Clinical

Long-term survival possible with radiofrequency ablation of liver tumors

Last Updated: 2011-12-21 16:58:02 -0400 (Reuters Health)

NEW YORK (Reuters Health) - In a study from Japan, one in four patients with hepatocellular carcinoma treated with percutaneous radiofrequency ablation (RFA) was still alive 10 years later.

"Our 10-year clinical experience shows that RFA could be locally curative, resulting in survival for as long as 10 years, and was a safe procedure," conclude the authors of the report in the American Journal of Gastroenterology online December 13.

RFA has become widely adopted for cases of unresectable hepatocellular carcinoma, and there have been several reports of five-year outcomes with the technique. Reports of 10-year outcomes are rare. Last year, Peng et al from Sun Yat-Sen University in Guangzhou, China reported a 10-year survival rate of 33.9% in 224 patients; all had well preserved liver function at baseline, and small solitary tumors.

The current paper, by Dr. Shuichiro Shiina and colleagues at the Graduate School of Medicine of the University of Tokyo, reports on progression, recurrence, and survival in a 10-year case series from their tertiary referral center.

Between 1999 and 2009, the team performed 2982 RFA treatments in 1170 primary HCC patients. Each treatment consisted of repeated procedures as needed, aimed at achieving complete tumor necrosis on CT imaging. Thus, a total of 4514 procedures were performed, resulting in complete ablation of 99.4% of treated tumors.

Complications such as GI perforation, hemoperitoneum, hepatic infarction or neoplastic seeding occurred in 67 of the 4514 procedures (1.5%), the report indicates.

Median follow-up was 38 months. Local tumor progression was only 3.4% at 10 years, the researchers found. However, rates of distant recurrence were 78.1% at five years and 80.8% at 10 years.

Overall survival was 60.2% at 5 years and 27.3% at 10 years. Hepatocellular carcinoma was the cause of death in 55.8% of cases, Dr. Shiina and colleagues report.

Compared to patients with tumors smaller than 2 cm, outcomes were worse in patients with tumors between 2 and 5 cm but not in those with tumors over 5 cm, the authors note. "This is probably because the number of patients with tumors > 5.0 cm (n = 35) were not large enough for the difference to be statistically significant," they comment.

The authors of a meta-analysis published early last year in the Journal of Hepatology, however, found that RFA is the best ablative therapy for HCC larger than 2 cm, but for smaller tumors, it's not clear whether RFA is best or whether cheaper, less invasive treatments work just as well (see Reuters Health story of January 29, 2010).

Summing up, the authors of the current report conclude, "RFA might be a first-line treatment for selected patients with early-stage HCC."

Peng et al, in last year's paper in the European Journal of Surgical Oncology, agreed. "RFA is considered to be the treatment of first choice for patients with solitary HCC (no larger than) 5 cm and well-preserved liver function," they wrote. "Surgery can be used as second-line therapy...if RFA is unfeasible."

There isn't unanimous agreement, however. This past August, a group from Taiwan reported that for patients with well preserved liver function and early or very early HCC, five-year survival was equivalent with either surgery or RFA, but disease-free survival was better with surgery. Sheng-Nan Lu et al concluded that while RFA may be an option for patients ineligible for surgery, surgery should be the first choice if liver transplantation is not an option (see Reuters Health story of August 3, 2011).

SOURCE: http://bit.ly/sCaeGV

Am J Gastroenterol 2011.

 
 
 
 
                 
 
HBV
Webcasts
Slide Library
Abstract Library
 
HE
CME Dinner Meeting
Webcasts
Slide Library
Abstract Library
 
HCC
Slide Library
Abstract Library
 
 
HCV
Webcasts
Slide Library
Abstract Library
 
CLDF Follow Us
   
 
About CLDF
Mission Statement
Board of Trustees
Board of Advisors
CLDF Supporters
 
Other Resources
Liver News Library
Journal Abstracts
Hep C Link to Care
 
Centers of
Educational Expertise
Regional Map
     
   
  The Chronic Liver Disease Foundation is a non-profit organization with content developed specifically for healthcare professionals.
© Copyright 2012-2014 Chronic Liver Disease Foundation. All rights reserved. This site is maintained as an educational resource for US healthcare providers only.
Use of this Web site is governed by the Chronic Liver Disease Foundation terms of use and privacy statement.