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Early-Stage Hepatocellular Carcinoma in Patients with Cirrhosis: Long-term Results of Percutaneous Image-guided Radiofrequency Ablation¹

¹ From the Division of Diagnostic and Interventional Radiology, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Via Roma 67, I-56125 Pisa, Italy. From the 2003 RSNA Annual Meeting. Received February 23, 2004; revision requested May 3; revision received July 2; accepted August 4. Address correspondence to R.L. (e-mail: lencioni@do.med.unipi.it).

View larger version (13K): [in a new window]   Figure 1. Graph shows the survival outcome of patients with liver cirrhosis and early-stage HCC in whom RF ablation was used as the sole first-line anticancer treatment. The difference between the survival curve for patients included in the intention-to-treat analysis (dotted line) and the survival curve for patients who actually received RF ablation (continuous line) is not statistically significant (P = .5094). The numbers of patients followed up for 1, 2, 3, 4, and 5 years were 119, 100, 62, 33, and 20 in the intention-to-treat analysis, and the numbers of patients followed up for 1, 2, 3, 4, and 5 years were 104, 86, 53, 29, and 18 in the analysis of patients treated with RF ablation.

View larger version (14K): [in a new window]   Figure 2. Graph shows the survival of early-stage HCC patients treated with RF ablation as relates to the severity of underlying cirrhosis. Patients with Child class A cirrhosis (n = 144, continuous line) had significantly better survival (P = .0006) than patients with Child class B cirrhosis (n = 43, dotted line).

View larger version (14K): [in a new window]   Figure 3. Graph shows the survival of early-stage HCC patients treated with RF ablation as relates to tumor multiplicity. Patients with a solitary tumor (n = 145, continuous line) had significantly better survival (P = .0133) than patients with multiple tumors (n = 42, dotted line).

View larger version (15K): [in a new window]   Figure 4. Graph shows tumor recurrence in patients with early-stage HCC who received RF ablation. Rates of recurrence within the treated tumor (ie, local tumor progression, dotted line) were 4% at 1 year, 10% at 3 years, and 10% at 5 years. Rates of recurrence with new tumors (continuous line) were 14% at 1 year, 49% at 3 years, and 81% at 5 years.