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Long-term outcomes and prognostic analysis of radiofrequency ablation for small hepatocellular carcinoma: 10-year follow-up in Chinese patients

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Abstract

Radiofrequency ablation (RFA) has been used as a curative therapy for small hepatocellular carcinoma (HCC). However, relatively little is known about the long-term outcome of RFA for small HCC in a background of hepatitis B infection, which is common among the Chinese population. Between May 2001 and May 2012, 837 patients with HCC nodules ≤3 cm treated with RFA were enrolled in this study. We evaluated long-term survival rates, local tumor progression rates, complications and the prognostic factors. Among 1020 tumor nodules in 837 patients, complete ablation was achieved in 98.8 % (1008/1020) and the 1-, 3-,5-, and 10-year overall survival rates were 91, 71, 54, and 33 %, respectively. Multivariate analysis revealed that tumor number [P = 0.003, hazard ratio (HR) 1.523, 95 % confidence interval (CI) 1.158–2.004], Child–Pugh grade (P = 0.001, HR 3.089, 95 % CI 2.238–4.266), and serum-glutamyltranspeptidase level (P = 0.002, HR 1.576, 95 % CI 1.251–1.985) were independent predictors of overall survival. The 1-, 3-, 5-, and 10-year recurrence-free survival rates were 74, 44, 30, and 15 %, respectively. Multivariate analysis revealed that serum α-fetoprotein level (P = 0.041, HR 1.249, 95 % CI 1.028–1.517) and tumor number (P = 0002, HR 1.449, 95 % CI 1.143–1.836) were independent predictors of recurrence-free survival. There were no procedure-related patient deaths and major complications occurred in 0.59 % (5/837) of patients. RFA achieved comparable long-term overall survival rates to those of surgical resection with fewer major complications and could therefore be considered as an alternative option for curative treatment of patients with small liver cancer.

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Abbreviations

RFA:

Radiofrequency ablation

HCC:

Hepatocellular carcinoma

HR:

Hazard ratio

CI:

Confidence interval

HCV:

Hepatitis C virus

HBV:

Hepatitis B virus

BCLC:

Barcelona Clinic Liver Cancer

AASLD:

American Association for the Study of Liver Diseases

TACE:

Transcatheter arterial chemoembolization

PEI:

Percutaneous ethanol injection

CT:

Computed tomography

MRI:

Magnetic resonance imaging

CA:

Complete ablation

IA:

Incomplete ablation

AFP:

Alpha-fetoprotein

GGT:

Glutamyltranspeptidase

OS:

Overall survival

DFS:

Disease-free survival

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Acknowledgments

This study was supported by a grant from the Zhongshan Hospital Clinical Research Development Program. We thank Xiaomei Yang at Cancer Liver Institute for the data collection.

Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Liver Cancer Institute, Zhongshan Hospital, Fudan University, 136 Xue Yuan Road, Shanghai, 200032, China

    Lan Zhang, Ning-Lin Ge, Yi Chen, Xiao-Ying Xie, Xin Yin, Yu-Hong Gan, Bo-Heng Zhang, Ju-Bo Zhang, Rong-Xin Chen, Yan-Hong Wang, Sheng-Long Ye & Zheng-Gang Ren

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

    Lan Zhang, Ning-Lin Ge, Yi Chen, Xiao-Ying Xie, Xin Yin, Yu-Hong Gan, Bo-Heng Zhang, Ju-Bo Zhang, Rong-Xin Chen, Yan-Hong Wang, Sheng-Long Ye & Zheng-Gang Ren

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  1. Lan Zhang
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Correspondence to Zheng-Gang Ren.

Additional information

Lan Zhang, Ning-Lin Ge, and Yi Chen have contributed equally to this paper.

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Zhang, L., Ge, NL., Chen, Y. et al. Long-term outcomes and prognostic analysis of radiofrequency ablation for small hepatocellular carcinoma: 10-year follow-up in Chinese patients. Med Oncol 32, 77 (2015). https://doi.org/10.1007/s12032-015-0532-z

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  • DOI: https://doi.org/10.1007/s12032-015-0532-z

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