The influence factors on therapeutic effect of radiofrequency ablation for hepatocellular carcinoma
Luo Min;Shi Meixin;Zhang Wei;Zhang Yu;Yang Xiuhua;Ding Hong;Department of Abdominal Ultra-sonography, the First Affiliated Hospital of Harbin Medical University;Department of Physical Diagnosis, the Second Hospital of Heilongjiang Province;
Objective To evaluate the prognostic factors of hepatocellular carcinoma(HCC) patients with treatment of ultrasound-guided pereutaneous radiofrequency ablation(RFA). Methods A total of 104 patients with 147 HCC tumors who had 36-month regular follow-up after percuatenous RFA therapy in the First Affiliated Hospital of Harbin Medical University between May 2008 tand June 2012 were included in this study. Contrast-enhanced ultrasound(CEUS) was the main method in evaluating the therapeutic effect of RFA. Kaplan-Meier model and Log-rank test were used in univariate analysis, and Cox regression model was used in multivariate analysis to identify the independent factors on therapeutic effect of RFA. Results The 0.5-, 1-, 2-, 3-year overall survival rates after RFA were 96.1%, 92.0%, 80.0%, 53.3% respectively, and the median survival time was 19 months. 1-year local recurrence rate was 13.6%. The univariate analysis showed that Child-Pugh classification, original lesion condition, intrahepatic recurrence, ablative area, and RFA priority were related to survival rate(χ2=7.119, P=0.008; χ2=20.485, P=0.000; χ2=14.160, P=0.000; χ2=11.825, P=0.001; χ2=7.979, P=0.005). The Child-Pugh classification, original lesion condition, intrahepatic recurrence were identified as independent prognostic factors of survival rate(P=0.001; P=0.005; P=0.003). The univariate analysis showed that virus marker, original lesion condition, hepatic background, tumor diameter, tumor boundary, relation with adjacent organ and vessels, ablative area, RFA priority weresignificantly related to local recurrence rate(χ2=7.234, P=0.007; χ2=9.083, P=0.003; χ2=7.791, P=0.005; χ2=13.042, P=0.000; χ2=20.657, P=0.000; χ2=58.615, P=0.000; χ2=6.681, P=0.010). The ablative area and tumor boundary were identified as independent prognostic factors of local recurrence rate(P=0.017; P=0.002). Conclusions Child-Pugh classification, original lesion condition, intrahepatic recurrence were identified as independent prognostic factors of survival. And ablative area and tumor boundary were identified as independent prognostic factors of local rcurrence rate. In order to improve patient`s survival and reduce local recurrence in high-risk cases, it is importantant to establish appropriate follow-up plan and multidisciplinary cooperation framework within a standard treatment procedure.
【CateGory Index】： R735.7