Reuters Health • The Doctor's Channel Daily Newscast
NEW YORK (Reuters Health) -
Radiofrequency ablation (RFA) is a viable alternative in patients with early hepatocellular carcinoma who are not candidates for surgery, Taiwanese researchers report in a July 11th on-line paper in the Journal of Hepatology. "For compensated patients in Barcelona Clinic Liver Cancer very early/early stage hepatocellular carcinoma," Dr. Sheng-Nan Lu, told Reuters Health by email, "RFA had an overall 5-year survival equal to surgical resection (SR) although SR yielded a better disease-free survival." Dr. Lu and colleagues at Chang Gung Memorial Hospital-Kaohsiung Medical Center note that increasing surveillance with ultrasound means that more patients are being diagnosed at an early stage. Surgery is the treatment of choice, but RFA is among other approaches. The choice of candidates for surgical resection, added Dr. Lu, "depended on the judgement of the surgeon and patients' preference. It might be contraindicated due to an abnormal ICG test, inadequate liver volume after resection, or other medical conditions."
The team retrospectively examined data on 605 patients, of whom 143 had very early disease and 462 had early disease. In the very early group, SR gave a 3-year overall survival of 98.0% and a 5-year overall survival of 91.5%. In the RFA group, corresponding proportions were 80.3% and 72.0%. Three and 5-year disease-free survival the rates were 62.1% and 40.7% for SR, and 39.8% and 29.3% for RFA. In the early group, SR give a 3-year overall survival of 87.8% and a 5-year overall survival of 77.2%. In the RFA group, corresponding proportions were 73.5% and 57.4%. For disease-free survival the rates were 59.9% and 50.8% for SR, and 28.3% and 14.4% for RFA. After adjustment there was no difference in overall survival, but disease-free survival was greater in the SR group. Thus concluded Dr. Lu, "RFA might be treatment of choice when SR is not feasible at initial assessment."
J Hepatol 2011
No comments:
Post a Comment