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Liver cancer in cirrhotic patients effectively treated with radiofrequency ablation
Date:12/16/2010

ncomplete responses (IRs)enhancing tissue at the tumor site, persistently elevated AFP levels, or both. An IR to laparoscopic RFA was classified as treatment failure (TF). When IR was observed after percutaneous RFA, the procedure was repeated within 15 days. An IR to the second percutaneous RFA treatment was then classified as a TF, with these patients then receiving selective transarterial chemoembolization (sTACE).

Results showed that CRs were obtained in 696 patients (98.5%) and 465 (66.8%) of these patients experienced a first recurrence during follow-up (median-29 months). RFA was repeated in 323 (69%) of patients with first recurrence, restoring disease-free status in 318 (98%) cases. In 223 patients there was a second recurrence and RFA was repeated in 147 (66%), with disease-free status obtained in 145 (98%) of cases.

"RFA is safe and effective for managing HCC in patients with cirrhosis," confirmed Dr. Rossi. Overall, 1326 HCC nodules were managed with 1921 RFA sessions (percutaneous-1840; laparoscopic-81), with no procedure-related deaths, and fewer than 1.0% of sessions with major complications. After repeated RFAs the estimated 3-year overall and disease-free survival rates were 67% and 40%; 5-year rates were 68% and 38%.

The researchers noted that optimal treatment strategies for cirrhotic patients with HCC is limited by the unpredictability of tumor progression, tumor understaging, and substantial risk of death unrelated to HCC. "Our experience indicates that RFA should be the treatment of choice for patients with one or two small HCCs," concluded Dr. Rossi. "Further research focusing on identifying tumor cell markers and genetic profiles associated with HCC growth patterns will ultimately help to develop individualized treatment strategies for managing liver cancer."


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