Virologic control and severity of liver disease determine survival after radiofrequency ablation of hepatocellular carcinoma on cirrhosis |
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Authors: | Manon Allaire Samia Rekik Richard Layese Annie Mumana Erwan Guyot Gisèle Nkontchou Valérie Bourcier Véronique Grando Marianne Ziol Pierre Nahon Nathalie Ganne-Carrié Olivier Sutter Etienne Audureau Olivier Seror Jean-Charles Nault |
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Institution: | 1. Department of hepatogastroenterology, CHU côte de Nacre, Caen, France;2. Liver unit, CHU Jean verdier, Bondy, France;3. Center of clinical research, Paris-Est university, A-TVB DHU, CEpiA (clinical epidemiology and ageing) unit EAA393, UPEC, Créteil, France;4. Department of biochemistry, CHU Jean Verdier, Bondy, France;5. Department of pathology, CHU Jean Verdier, Bondy, France;6. Inserm UMR1162, Paris, France;7. Department of radiology, CHU Jean Verdier, Bondy, France |
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Abstract: | BackgroundWe aimed to identify the main determinants of long-term overall survival (OS), including virologic control, and recurrence after radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) on cirrhosis.MethodsCirrhotic patients treated by RFA for HCC within Milan criteria were included. Associations between patient features and events were estimated by the Kaplan–Meier method with the log rank test and using uni/multivariate Cox models.Results389 cirrhotic patients (Child–Pugh A 86.6%, 473 tumors) were included. OS was 79.8%, 42.4% and 16%, and overall tumor recurrence 45%, 78% and 88% at 2, 5 and 10 years, respectively. In multivariate analysis, age, Child–Pugh, GGT, HCC near major vessels, esophageal varices, alkaline phosphatase and HBV predicted OS. Gender, ALT, AFP and alcohol intake were associated with tumor recurrence. Multinodular HCC (19.5%) was associated with risk of tumor recurrence outside Milan criteria. HBV patients had longer OS than other patients (P?=?0.0059); negative HBV PCR at RFA was associated with decreased tumor recurrence (P?=?0.0157). Using time-dependent analysis in HCV patients, a sustained virologic response was associated with increased OS (124.5 months) compared to other patients (49.2 months, P?<?0.001).ConclusionVirologic response and severity of underlying liver disease were the main determinants of long-term OS after RFA for HCC developing on cirrhosis. |
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Keywords: | Hepatocellular carcinoma Radiofrequency ablation Viral control |
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