Outcomes of nontransplant potentially curative therapy for early-stage hepatocellular carcinoma in child-pugh stage a cirrhosis is comparable with liver transplantation

被引:26
作者
Takahashi, Shunsuke
Kudo, Masatoshi
Chung, Hobyung
Inoue, Tatsuo
Nagashima, Miki
Kitai, Satoshi
Chie, Tatsumi
Yasunori, Minami
Kazuomi, Ueshima
Toyokazu, Fukunaga
Haji, Seiji
机构
[1] Kinki Univ, Sch Med, Dept Internal Med, Div Gastroenterol & Hepatol, Osakasayama 5898511, Japan
[2] Kinki Univ, Sch Med, Dept Surg, Osakasayama, Japan
关键词
hepatocellular carcinoma; liver transplantation; Milan criteria; liver resection; radiofrequency ablation; LONG-TERM SURVIVAL; RADIOFREQUENCY ABLATION; LIVING DONOR; HEPATITIS-C; ETHANOL INJECTION; INTERFERON-ALPHA; RECURRENCE; RESECTION; JAPAN;
D O I
10.1159/000106909
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: This study was undertaken to assess the outcome of potentially curative therapy for early-stage hepatocellular carcinoma (HCC) in patients with Child-Pugh stage A cirrhosis as well as to investigate the impact of low-dose interferon (IFN) therapy after curative therapy on survival. Methods: This study retrospectively evaluated clinical outcomes in a cohort of 224 Child-Pugh stage A cirrhotic patients who received either resection ( 53 cases) or radiofrequency ablation ( RFA: 171 cases) for HCC within Milan criteria. Thirty patients were treated with low-dose maintenance IFN therapy after initial curative therapy. The median follow- up period was 36.7 months. Results: The 5-year survival rate of all patients was 74.9%, with similar rates for the resection and RFA groups (70.4 vs. 76.8%; p = 0.561). The 5-year HCC recurrence rate was higher in the RFA group than the resection group (85.3 vs. 73.2%; p = 0.012). The maintenance IFN-treated group maintained their liver function within Child-Pugh stage A for a significantly longer time (median time 36.9 vs. 32.2 months; p = 0.0025). Conclusion: The 5-year outcomes of resection and RFA in patients with Child-Pugh stage A cirrhosis and early stage HCC were comparable with liver transplantation. Low-dose, long-term maintenance IFN therapy after curative therapy was significantly beneficial on survival.
引用
收藏
页码:303 / 309
页数:7
相关论文
共 20 条
[1]   Surgical management of hepatocellular carcinoma: Resection and ablation [J].
Choti, MA .
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2002, 13 (09) :S197-S203
[2]   Small hepatocellular carcinoma in cirrhosis: Randomized comparison of radio-frequency thermal ablation versus percutaneous ethanol injection [J].
Lencioni, RA ;
Allgaier, HP ;
Cioni, D ;
Olschewski, M ;
Deibert, P ;
Crocetti, L ;
Frings, H ;
Laubenberger, J ;
Zuber, I ;
Blum, HE ;
Bartolozzi, C .
RADIOLOGY, 2003, 228 (01) :235-240
[3]   Liver transplantation outcomes for early-stage hepatocellular carcinoma: Results of a multicenter study [J].
Leung, JY ;
Zhu, AX ;
Gordon, FD ;
Pratt, DS ;
Mithoefer, A ;
Garrigan, K ;
Terella, A ;
Hertl, M ;
Cosimi, AB ;
Chung, RT .
LIVER TRANSPLANTATION, 2004, 10 (11) :1343-1354
[4]   Radiofrequency ablation improves prognosis compared with ethanol injection for hepatocellular carcinoma ≤4cm [J].
Lin, SM ;
Lin, CJ ;
Lin, CC ;
Hsu, CW ;
Chen, YC .
GASTROENTEROLOGY, 2004, 127 (06) :1714-1723
[5]   Prospective randomized controlled study of interferon-alpha in preventing hepatocellular carcinoma recurrence after medical ablation therapy for primary tumors [J].
Lin, SM ;
Lin, CJ ;
Hsu, CW ;
Tai, DI ;
Sheen, IS ;
Lin, DY ;
Liaw, YF .
CANCER, 2004, 100 (02) :376-382
[6]   Intention-to-treat analysis of surgical treatment for early hepatocellular carcinoma: Resection versus transplantation [J].
Llovet, JM ;
Fuster, J ;
Bruix, J .
HEPATOLOGY, 1999, 30 (06) :1434-1440
[7]   Radiofrequency ablation of small hepatocellular carcinoma in cirrhotic patients awaiting liver transplantation -: A prospective study [J].
Mazzaferro, V ;
Battiston, C ;
Perrone, S ;
Pulvirenti, A ;
Regalia, E ;
Romito, R ;
Sarli, D ;
Schiavo, M ;
Garbagnati, F ;
Marchianò, A ;
Spreafico, C ;
Camerini, T ;
Mariani, L ;
Miceli, R ;
Andreola, S .
ANNALS OF SURGERY, 2004, 240 (05) :900-909
[8]   RANDOMIZED TRIAL OF EFFECTS OF INTERFERON-ALPHA ON INCIDENCE OF HEPATOCELLULAR-CARCINOMA IN CHRONIC ACTIVE HEPATITIS-C WITH CIRRHOSIS [J].
NISHIGUCHI, S ;
KUROKI, T ;
NAKATANI, S ;
MORIMOTO, H ;
TAKEDA, T ;
NAKAJIMA, S ;
SHIOMI, S ;
SEKI, S ;
KOBAYASHI, K ;
OTANI, S .
LANCET, 1995, 346 (8982) :1051-1055
[9]   Long-term survival and pattern of recurrence after resection of small hepatocellular carcinoma in patients with preserved liver function - Implications for a strategy of salvage transplantation [J].
Poon, RTP ;
Fan, ST ;
Lo, CM ;
Liu, CL ;
Wong, J .
ANNALS OF SURGERY, 2002, 235 (03) :373-382
[10]   Low-dose, long-term, intermittent interferon-alpha-2b therapy after radical treatment by radiofrequency ablation delays clinical recurrence in patients with hepatitis C virus-related hepatocellular carcinoma [J].
Sakaguchi, Y ;
Kudo, M ;
Fukunaga, T ;
Minami, Y ;
Chung, H ;
Kawasaki, T .
INTERVIROLOGY, 2005, 48 (01) :64-70