|Efficacy and feasibility of radiofrequency ablation for decompensated cirrhotic patients with hepatocellular carcinoma|
|Wu Jin-yu3; Yang Wei1; Cui Ming2; Yin Shan-shan1; Gao Wen1; Wu Wei1; Yan Kun1; Chen Min-hua1|
|关键词||Child-pugh Classification Liver Function Decompensation Hepatocellular Carcinoma Radiofrequency Ablation Ultrasound Guidance|
|刊名||CHINESE MEDICAL JOURNAL|
|WOS标题词||Science & Technology|
|类目[WOS]||Medicine, General & Internal|
|研究领域[WOS]||General & Internal Medicine|
|关键词[WOS]||LIVER-TUMORS ; PROGNOSTIC-FACTORS ; RESECTION ; CANCER ; TRANSPLANTATION ; MANAGEMENT|
Background Most HCC patients with decompensation of liver function lost the chance of surgical and/or interventional treatment. The aim of this study was to evaluate feasibility and outcome of radiofrequency ablation (RFA) in treating hepatocellular carcinoma (HCC) patients with poor liver function (Child-Pugh class C), who are not suitable for surgery or hepatic artery chemo-embolization.
Methods Thirteen HCC patients (the number of tumors was 17) with liver function of Child-Pugh C (scores: 10.2 +/- 0.4) were included in the study. Among the patients, 8 were male and 5 were female with the average age of (61.6 +/- 10.9) years old. The average size of HCC was (3.8 +/- 1.0) cm. Two patients were recurrent HCC and 30.8% of the patients had multiple tumors (2-3 tumors). All the patients were treated with RFA.
Results There were 22 RFA sessions (1-4 sessions per patient) in all, average ablations per tumor at first session was 3.1. One week after RFA, the liver enzymes elevated in 9 patients (69.2%), in 7 of them, the liver enzyme returned to pre-RFA level in 1-3 months. One month after RFA, the Child-Pugh grading was 10.3 +/- 0.8 (Child-Pugh C), while that of pre-RFA was 10.2 +/- 0.4 (Child-Pugh C), with no significant difference. Computer tomography (CT) one month after RFA showed that the tumor necrosis rate was 88.2% (15/17). Five patients had 2-4 repeated RFA due to HCC recurrence. During the follow-up of 2-69 months in this group, survival rate of one year was 53.8%, two years was 30.8%, and three year was 15.4%. The incidence of RFA-related complications was 13.6% (3/22 sessions), including 1 case of GI hemorrhage and 1 sub-capsular hemorrhage of the liver. One patient with HCC over 5 cm who had fever and liver abscess after RFA, and was dead 2 months later due to liver function failure.
Conclusions Minimal invasive RFA provides possible treatment modality for HCC patients with poor liver function, who are not candidates for surgical and/or interventional therapy. For large HCC, due to the required extended treatment region, special attention should be paid to the possibility of acute liver failure. Chin Med J 2010;123(15):1967-1972
|资助机构||Chinese National High Technology Research and Development Program 863|
|作者单位||1.Peking Univ, Sch Oncol, Beijing Canc Hosp & Inst, Dept Ultrasound, Beijing 100142, Peoples R China|
2.Peking Univ, Sch Oncol, Beijing Canc Hosp & Inst, Dept Surg Oncol, Beijing 100142, Peoples R China
3.Harbin First Hosp, Dept Ultrasound, Harbin 150010, Heilongjiang, Peoples R China
|Wu Jin-yu,Yang Wei,Cui Ming,et al. Efficacy and feasibility of radiofrequency ablation for decompensated cirrhotic patients with hepatocellular carcinoma[J]. CHINESE MEDICAL JOURNAL,2010,123(15):1967-1972.|
|APA||Wu Jin-yu.,Yang Wei.,Cui Ming.,Yin Shan-shan.,Gao Wen.,...&Chen Min-hua.(2010).Efficacy and feasibility of radiofrequency ablation for decompensated cirrhotic patients with hepatocellular carcinoma.CHINESE MEDICAL JOURNAL,123(15),1967-1972.|
|MLA||Wu Jin-yu,et al."Efficacy and feasibility of radiofrequency ablation for decompensated cirrhotic patients with hepatocellular carcinoma".CHINESE MEDICAL JOURNAL 123.15(2010):1967-1972.|