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Abstract：
UNASSIGNED: Radiofrequency ablation (RFA) is a standard treatment for small inoperable hepatocellular carcinoma (HCC). Studies on mid- and long-term outcome of RFA as first-line therapy for HCC from India are limited.
UNASSIGNED: We evaluated consecutive HCC patients who underwent RFA as primary treatment modality at our institute between July 2009 and April 2016. The median follow-up period was 26 months, range 1-84 months. We evaluated post-RFA tumor response, disease-free survival (DFS), overall survival (OS), and local tumor progression (LTP). Prognostic factors were also analyzed.
UNASSIGNED: In 147 patients (male:female = 121:26; mean age, 59.2 years), 209 RFA sessions were done for 228 lesions (mean size of 21.5 ± 8.3 mm, range 10-50 mm). Primary success rate was 94.2%. The estimated cumulative proportion survival at 1, 3, and 5 years was 90.2%, 63.8%, and 60.2%, respectively. The cumulative incidence of LTP estimated at 1, 3, and 5 years was 13.1%, 19.7%, and 20.1%, respectively. The mean estimate of LTP-free survival was 53.6 months (95% confidence interval: 0.49-0.58) which is 58.2 months in <3 cm lesions and 20.4 months in >3 cm lesions (P < 0.01). There was no significant difference in LTP rates between lesions in perivascular versus nonperivascular location (P = 0.71) and surface versus parenchymal lesions (P = 0.66). The mean DFS was 30.3 months (95% CI: 25.6-35.0). For OS, age and Child-Turcotte-Pugh class B were significant factors while for LTP, tumor size >3 cm was significant. Higher baseline alpha-fetoprotein level and LTP were poor predictors for DFS. Complication rate per RFA session was 7/209 (3.3%).
UNASSIGNED: RFA is a safe and effective curative modality for first-line treatment of HCC < 3 cm.
UNASSIGNED: We evaluated consecutive HCC patients who underwent RFA as primary treatment modality at our institute between July 2009 and April 2016. The median follow-up period was 26 months, range 1-84 months. We evaluated post-RFA tumor response, disease-free survival (DFS), overall survival (OS), and local tumor progression (LTP). Prognostic factors were also analyzed.
UNASSIGNED: In 147 patients (male:female = 121:26; mean age, 59.2 years), 209 RFA sessions were done for 228 lesions (mean size of 21.5 ± 8.3 mm, range 10-50 mm). Primary success rate was 94.2%. The estimated cumulative proportion survival at 1, 3, and 5 years was 90.2%, 63.8%, and 60.2%, respectively. The cumulative incidence of LTP estimated at 1, 3, and 5 years was 13.1%, 19.7%, and 20.1%, respectively. The mean estimate of LTP-free survival was 53.6 months (95% confidence interval: 0.49-0.58) which is 58.2 months in <3 cm lesions and 20.4 months in >3 cm lesions (P < 0.01). There was no significant difference in LTP rates between lesions in perivascular versus nonperivascular location (P = 0.71) and surface versus parenchymal lesions (P = 0.66). The mean DFS was 30.3 months (95% CI: 25.6-35.0). For OS, age and Child-Turcotte-Pugh class B were significant factors while for LTP, tumor size >3 cm was significant. Higher baseline alpha-fetoprotein level and LTP were poor predictors for DFS. Complication rate per RFA session was 7/209 (3.3%).
UNASSIGNED: RFA is a safe and effective curative modality for first-line treatment of HCC < 3 cm.
摘要：
■射频消融（RFA）是小型无法手术的肝细胞癌（HCC）的标准治疗方法。关于RFA作为来自印度的HCC的一线治疗的中期和长期结果的研究是有限的。
■我们评估了2009年7月至2016年4月在我们研究所接受RFA作为主要治疗方式的连续HCC患者。中位随访期为26个月,范围1-84个月。我们评估了RFA后的肿瘤反应，无病生存率（DFS），总生存期（OS），和局部肿瘤进展(LTP)。还分析了预后因素。
■147名患者（男性：女性=121:26；平均年龄，59.2年），对228个病灶进行209次RFA治疗(平均大小为21.5±8.3mm,范围10-50毫米）。一次成功率为94.2%。估计1年、3年和5年的累积生存率为90.2%，63.8%,和60.2%，分别。LTP在1年、3年和5年的累积发病率为13.1%，19.7%,20.1%，分别。无LTP生存期的平均估计值为53.6个月（95％置信区间：0.49-0.58），<3cm病变为58.2个月，>3cm病变为20.4个月（P<0.01）。血管周围与非血管周围病变（P=0.71）和表面与实质病变（P=0.66）之间的LTP率没有显着差异。平均DFS为30.3个月（95％CI：25.6-35.0）。对于操作系统，年龄和Child-Turcotte-PughB级是重要因素，而对于LTP，肿瘤大小>3cm是显著的。较高的基线甲胎蛋白水平和LTP是DFS的不良预测因子。每个RFA疗程的并发症率为7/209（3.3%）。
■RFA是<3cm肝癌一线治疗的一种安全有效的治疗方法。
■我们评估了2009年7月至2016年4月在我们研究所接受RFA作为主要治疗方式的连续HCC患者。中位随访期为26个月,范围1-84个月。我们评估了RFA后的肿瘤反应，无病生存率（DFS），总生存期（OS），和局部肿瘤进展(LTP)。还分析了预后因素。
■147名患者（男性：女性=121:26；平均年龄，59.2年），对228个病灶进行209次RFA治疗(平均大小为21.5±8.3mm,范围10-50毫米）。一次成功率为94.2%。估计1年、3年和5年的累积生存率为90.2%，63.8%,和60.2%，分别。LTP在1年、3年和5年的累积发病率为13.1%，19.7%,20.1%，分别。无LTP生存期的平均估计值为53.6个月（95％置信区间：0.49-0.58），<3cm病变为58.2个月，>3cm病变为20.4个月（P<0.01）。血管周围与非血管周围病变（P=0.71）和表面与实质病变（P=0.66）之间的LTP率没有显着差异。平均DFS为30.3个月（95％CI：25.6-35.0）。对于操作系统，年龄和Child-Turcotte-PughB级是重要因素，而对于LTP，肿瘤大小>3cm是显著的。较高的基线甲胎蛋白水平和LTP是DFS的不良预测因子。每个RFA疗程的并发症率为7/209（3.3%）。
■RFA是<3cm肝癌一线治疗的一种安全有效的治疗方法。
