Treatment of hepatocellular carcinoma in compensated cirrhosis with radio-frequency thermal ablation (RFTA):: a prospective study

Background/Aims: To assess the effectiveness and the safety of radio-frequency thermal ablation (RFTA) in patients with hepatocellular carcinoma (HCC) <= 5 cm in compensated cirrhosis. Methods: A cohort of 202 consecutive patients (165 Child-Pugh class A and 37 class B) was prospectively assessed. A single lesion was observed in 160/202 (79.2%), two lesions in 29/202 (14.3%), and three lesions in 13/202 (6.4%) of patients. Results: Sixty-seven patients died. Survival rates were 80% at 12 months, 67% at 24 months and 57% at 30 months (Child-Pugh A 59% and Child-Pugh B 48%). By Cox regression analysis, survival was independently predicted by serum albumin levels >= 35 g/L, platelet count >= 100.000/mmc, tumor size <= 3 cm, complete response at I month and Barcelona Clinic Liver Cancer (BCLC) staging classification. Overall recurrence rates were 22, 38, and 44% at 12, 24, and 30 months, respectively. One procedure-related death occurred. The proportion of major complications after treatment was 3.9%. Conclusions: A complete response after RFTA significantly increases survival. The longest survival is obtained in the presence of HCC <= 3 cm and of higher baseline albumin levels and platelet counts. BCLC staging classification is able to discriminate patients with good or poor prognosis. (C) 2005 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.