Delay in treatment of early-stage hepatocellular carcinoma using radiofrequency ablation may impact survival of cirrhotic patients in a surveillance program

J Surg Oncol. 2011 Feb;103(2):133-9. doi: 10.1002/jso.21797. Epub 2010 Dec 7.

Abstract

Background: The aim of this study was to evaluate the impact of the interval between diagnosis and treatment using radiofrequency (RF) ablation on the survival of patients with HCC detected through a surveillance program.

Methods: Between January 2004 and July 2007, 121 cirrhotic patients with 157 tumours detected through a surveillance program underwent RF ablation. A delay in treatment was defined as >5 weeks. The mean length of follow-up was 25 months (range 8-55 months). Cumulative survival of patients was analysed using the Kaplan-Meier method. Cox regression models were used to identify factors associated with patient survival.

Results: The 1-, 2- and 3-year survival rates were 92.5%, 78.5% and 67.2%. The independent predictors of poorer patient survival were time from diagnosis to treatment >5 weeks (pooled odds ratio [OR], 3.59; 95% confidence interval [CI], 1.58-8.18; P = 0.002), absence of complete ablation after the initial RF session (OR, 2.42; 95% CI 1.07-5.45; P = 0.033) and Child-Pugh B liver cirrhosis (OR, 2.46; 95% CI 1.06-5.70; P = 0.036).

Conclusions: Delay in the start of effective treatment for HCC using RF ablation may be associated with poorer patient survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular / diagnosis
  • Carcinoma, Hepatocellular / epidemiology*
  • Carcinoma, Hepatocellular / surgery*
  • Catheter Ablation*
  • Chronic Disease
  • Comorbidity
  • Confidence Intervals
  • Delayed Diagnosis
  • Female
  • Follow-Up Studies
  • Humans
  • Liver Cirrhosis / mortality*
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / epidemiology*
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Population Surveillance
  • Prospective Studies
  • Survival Rate