Efficacy and Safety of Combined Radiofrequency Ablation with Transarterial Chemoembolization in Patients with Barcelona Clinic Liver Cancer Stage A Hepatocellular Carcinoma Ineligible for Curative Treatment
김아란, 박유진, 권소영, 박성준, 김영중, 유병철, 최원혁, 김정한, 황진호, 박상우, 김영준, 박희선, 유미혜, 전혜정,
소속 상세정보
김아란 ( Kim Ah-Ran )
Konkuk University School of Medicine Department of Internal Medicine
박유진 ( Park Eu-Gene )
Konkuk University School of Medicine Department of Internal Medicine
권소영 ( Kwon So-Young )
Konkuk University School of Medicine Department of Internal Medicine
박성준 ( Park Seong-Jun )
Konkuk University School of Medicine Department of Internal Medicine
김영중 ( Kim Young-Jung )
Konkuk University School of Medicine Department of Internal Medicine
유병철 ( Yoo Byung-Chul )
Konkuk University School of Medicine Department of Internal Medicine
최원혁 ( Choe Won-Hyeok )
Konkuk University School of Medicine Department of Internal Medicine
김정한 ( Kim Jeong-Han )
Konkuk University School of Medicine Department of Internal Medicine
황진호 ( Hwang Jin-Ho )
Konkuk University School of Medicine Department of Radiology
박상우 ( Park Sang-Woo )
Konkuk University School of Medicine Department of Radiology
김영준 ( Kim Young-Jun )
Konkuk University School of Medicine Department of Radiology
박희선 ( Park Hee-Sun )
Konkuk University School of Medicine Department of Radiology
유미혜 ( Yu Mi-Hye )
Konkuk University School of Medicine Department of Radiology
전혜정 ( Jeon Hae-Jeong )
Konkuk University School of Medicine Department of Radiology
Abstract
Background/Aims: Surgical resection or ablation is recommended for the treatment of early hepatocellular carcinoma (HCC), whereas transarterial chemoembolization (TACE) is frequently used in early HCC ineligible for curative resection. We evaluated the clinical effects and safety of radiofrequency ablation (RFA) shortly after TACE in patients with Barcelona clinic liver cancer (BCLC) stage A HCC.
Methods: Sixty-seven BCLC stage A HCC patients who failed to achieve complete response to TACE as either a first line treatment and who subsequently received RFA at the Konkuk University Medical Center from January 2005 to December 2017 were included. Evaluation indices included treatment response, overall survival rate, recurrence-free survival, prognostic factors, and procedure-related complications.
Results: Median follow-up was 46.9 months. Fifty-four (80.6%) patients were of Child-Pugh class A, and 13 (19.4%) were of class B. Modified UICC stages were I in 10 (14.9%), II in 46 (68.7%), and III in 11 (16.4%) patients. In the 67 study subjects, cumulative recurrence-free survival rates were 86.8%, 55.9% and 29.7% at 1, 3, and 5 years, respectively, and overall survival rates were 100%, 93.4%, and 83.5% at 1, 3, and 5 years, respectively. Tumor size significantly predicted recurrence. No treatment-related death occurred.
Conclusions: Combination of RFA was an efficient and safe treatment for BCLC stage A HCC patients that failed to achieve complete response to initial TACE. We suggest TACE plus RFA be considered as a curative option for early HCC patients ineligible for curative resection of RFA.
키워드
Hepatocellular carcinoma; Transarterial chemoembolization; Radiofrequency ablation; Treatment outcome
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