Treatment strategy for hepatocellular carcinoma: expanding the indications for radiofrequency ablation
Background Radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is ordinarily indicated for those with three or fewer nodules, none of which exceeds 3 cm in diameter. This study investigated whether an apparent threshold exists in the diameter and number of nodules in terms of the progno...
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| Veröffentlicht in: | Journal of gastroenterology 2009-01, Vol.44 (19), p.142-146 |
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| creator | Tateishi, Ryosuke Shiina, Shuichiro Ohki, Takamasa Sato, Takahisa Masuzaki, Ryota Imamura, Jun Goto, Eriko Goto, Tadashi Yoshida, Hideo Obi, Shuntaro Sato, Shinpei Kanai, Fumihiko Yoshida, Haruhiko Omata, Masao |
| description | Background Radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is ordinarily indicated for those with three or fewer nodules, none of which exceeds 3 cm in diameter. This study investigated whether an apparent threshold exists in the diameter and number of nodules in terms of the prognosis of patients with HCC. Methods We enrolled 663 naïve patients with HCC who were treated with RFA at our hospital between 1999 and 2005. We analyzed the patients' prognosis using multivariate Cox proportional regression with the diameter and number of nodules as covariates and Child-Pugh class as a stratification factor. The diameter and number were categorized as 5 cm and 1, 2-3, 4-5, and >5, respectively. Results The adjusted hazard ratio of patients whose largest nodule was 5 cm was 1, 1.51, 2.56, 2.25, and 2.71, respectively. The adjusted hazard ratio of patients with one, two or three, four or five, and more than five nodules was 1, 1.35, 1.70, and 2.12, respectively. Therefore, patients with three or fewer nodules, none of which exceeds 5 cm in diameter, have a 5-year survival of 40%. Conclusions The prognosis of the patients worsened gradually as the diameter and number of nodules increased. No apparent threshold in the diameter or number of HCC nodules was detected. RFA can be applied beyond the conventional indications. |
| doi_str_mv | 10.1007/s00535-008-2247-9 |
| format | Article |
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This study investigated whether an apparent threshold exists in the diameter and number of nodules in terms of the prognosis of patients with HCC. Methods We enrolled 663 naïve patients with HCC who were treated with RFA at our hospital between 1999 and 2005. We analyzed the patients' prognosis using multivariate Cox proportional regression with the diameter and number of nodules as covariates and Child-Pugh class as a stratification factor. The diameter and number were categorized as <=2.0, 2.1-3.0, 3.1-4.0, 4.1-5.0, and >5 cm and 1, 2-3, 4-5, and >5, respectively. Results The adjusted hazard ratio of patients whose largest nodule was <=2.0, 2.1-3.0, 3.1-4.0, 4.1-5.0, and >5 cm was 1, 1.51, 2.56, 2.25, and 2.71, respectively. The adjusted hazard ratio of patients with one, two or three, four or five, and more than five nodules was 1, 1.35, 1.70, and 2.12, respectively. Therefore, patients with three or fewer nodules, none of which exceeds 5 cm in diameter, have a 5-year survival of 40%. Conclusions The prognosis of the patients worsened gradually as the diameter and number of nodules increased. No apparent threshold in the diameter or number of HCC nodules was detected. RFA can be applied beyond the conventional indications.</description><identifier>ISSN: 0944-1174</identifier><identifier>EISSN: 1435-5922</identifier><identifier>DOI: 10.1007/s00535-008-2247-9</identifier><identifier>PMID: 19148809</identifier><language>eng</language><publisher>Japan: Japan : Springer Japan</publisher><subject>Abdominal Surgery ; Aged ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - therapy ; Catheter Ablation - methods ; Cohort Studies ; Colorectal Surgery ; Female ; Follow-Up Studies ; Gastroenterology ; Hepatology ; hepatoma ; Humans ; International Forum 2 ; Liver Neoplasms - mortality ; Liver Neoplasms - pathology ; Liver Neoplasms - therapy ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Prognosis ; Proportional Hazards Models ; radiofrequency ablation ; Retrospective Studies ; Surgical Oncology ; survival analysis ; Survival Rate ; Treatment Outcome</subject><ispartof>Journal of gastroenterology, 2009-01, Vol.44 (19), p.142-146</ispartof><rights>Springer Japan 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c488t-2b21405ab796f624a4c404b198880538a665b7c8cb7c1068c49df2b449ec2c7d3</citedby><cites>FETCH-LOGICAL-c488t-2b21405ab796f624a4c404b198880538a665b7c8cb7c1068c49df2b449ec2c7d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00535-008-2247-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00535-008-2247-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19148809$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tateishi, Ryosuke</creatorcontrib><creatorcontrib>Shiina, Shuichiro</creatorcontrib><creatorcontrib>Ohki, Takamasa</creatorcontrib><creatorcontrib>Sato, Takahisa</creatorcontrib><creatorcontrib>Masuzaki, Ryota</creatorcontrib><creatorcontrib>Imamura, Jun</creatorcontrib><creatorcontrib>Goto, Eriko</creatorcontrib><creatorcontrib>Goto, Tadashi</creatorcontrib><creatorcontrib>Yoshida, Hideo</creatorcontrib><creatorcontrib>Obi, Shuntaro</creatorcontrib><creatorcontrib>Sato, Shinpei</creatorcontrib><creatorcontrib>Kanai, Fumihiko</creatorcontrib><creatorcontrib>Yoshida, Haruhiko</creatorcontrib><creatorcontrib>Omata, Masao</creatorcontrib><title>Treatment strategy for hepatocellular carcinoma: expanding the indications for radiofrequency ablation</title><title>Journal of gastroenterology</title><addtitle>J Gastroenterol</addtitle><addtitle>J Gastroenterol</addtitle><description>Background Radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is ordinarily indicated for those with three or fewer nodules, none of which exceeds 3 cm in diameter. This study investigated whether an apparent threshold exists in the diameter and number of nodules in terms of the prognosis of patients with HCC. Methods We enrolled 663 naïve patients with HCC who were treated with RFA at our hospital between 1999 and 2005. We analyzed the patients' prognosis using multivariate Cox proportional regression with the diameter and number of nodules as covariates and Child-Pugh class as a stratification factor. The diameter and number were categorized as <=2.0, 2.1-3.0, 3.1-4.0, 4.1-5.0, and >5 cm and 1, 2-3, 4-5, and >5, respectively. Results The adjusted hazard ratio of patients whose largest nodule was <=2.0, 2.1-3.0, 3.1-4.0, 4.1-5.0, and >5 cm was 1, 1.51, 2.56, 2.25, and 2.71, respectively. The adjusted hazard ratio of patients with one, two or three, four or five, and more than five nodules was 1, 1.35, 1.70, and 2.12, respectively. Therefore, patients with three or fewer nodules, none of which exceeds 5 cm in diameter, have a 5-year survival of 40%. Conclusions The prognosis of the patients worsened gradually as the diameter and number of nodules increased. No apparent threshold in the diameter or number of HCC nodules was detected. RFA can be applied beyond the conventional indications.</description><subject>Abdominal Surgery</subject><subject>Aged</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - therapy</subject><subject>Catheter Ablation - methods</subject><subject>Cohort Studies</subject><subject>Colorectal Surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>hepatoma</subject><subject>Humans</subject><subject>International Forum 2</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - therapy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>radiofrequency ablation</subject><subject>Retrospective Studies</subject><subject>Surgical Oncology</subject><subject>survival analysis</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0944-1174</issn><issn>1435-5922</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kU9v1DAQxS0EokvhA3CBiAO3wIzjxDY3VPFPqsSB9mxNHGebKrEX25HYb4-3WakSBy625fm9mWc_xl4jfEAA-TEBtE1bA6iacyFr_YTtUJSbVnP-lO1AC1EjSnHBXqR0D4ANtOo5u0CNQinQOzbeREd5cT5XKUfKbn-sxhCrO3egHKyb53WmWFmKdvJhoU-V-3MgP0x-X-U7V03laClPwacHXaRhCmN0v1fn7bGifn4ovmTPRpqTe3XeL9nt1y83V9_r65_fflx9vq5t8ZNr3nMU0FIvdTd2XJCwAkSPWhW3baOo69peWmXLgtApK_Qw8l4I7Sy3cmgu2fut7yGGYiFls0zp9AryLqzJdJ1CKRUU8N0_4H1Yoy_eDEeJHQglCoQbZGNIKbrRHOK0UDwaBHNKwGwJmJKAOSVgdNG8OTde-8UNj4rzlxeAb0AqJb938XHy_7q-3UQjBUP7OCVz-4uf8sRWccmb5i_6npsU</recordid><startdate>20090101</startdate><enddate>20090101</enddate><creator>Tateishi, Ryosuke</creator><creator>Shiina, Shuichiro</creator><creator>Ohki, Takamasa</creator><creator>Sato, Takahisa</creator><creator>Masuzaki, Ryota</creator><creator>Imamura, Jun</creator><creator>Goto, Eriko</creator><creator>Goto, Tadashi</creator><creator>Yoshida, Hideo</creator><creator>Obi, Shuntaro</creator><creator>Sato, Shinpei</creator><creator>Kanai, Fumihiko</creator><creator>Yoshida, Haruhiko</creator><creator>Omata, Masao</creator><general>Japan : Springer Japan</general><general>Springer Japan</general><general>Springer Nature B.V</general><scope>FBQ</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>8BM</scope></search><sort><creationdate>20090101</creationdate><title>Treatment strategy for hepatocellular carcinoma: expanding the indications for radiofrequency ablation</title><author>Tateishi, Ryosuke ; Shiina, Shuichiro ; Ohki, Takamasa ; Sato, Takahisa ; Masuzaki, Ryota ; Imamura, Jun ; Goto, Eriko ; Goto, Tadashi ; Yoshida, Hideo ; Obi, Shuntaro ; Sato, Shinpei ; Kanai, Fumihiko ; Yoshida, Haruhiko ; Omata, Masao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c488t-2b21405ab796f624a4c404b198880538a665b7c8cb7c1068c49df2b449ec2c7d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Abdominal Surgery</topic><topic>Aged</topic><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - therapy</topic><topic>Catheter Ablation - methods</topic><topic>Cohort Studies</topic><topic>Colorectal Surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>hepatoma</topic><topic>Humans</topic><topic>International Forum 2</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - therapy</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>radiofrequency ablation</topic><topic>Retrospective Studies</topic><topic>Surgical Oncology</topic><topic>survival analysis</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tateishi, Ryosuke</creatorcontrib><creatorcontrib>Shiina, Shuichiro</creatorcontrib><creatorcontrib>Ohki, Takamasa</creatorcontrib><creatorcontrib>Sato, Takahisa</creatorcontrib><creatorcontrib>Masuzaki, Ryota</creatorcontrib><creatorcontrib>Imamura, Jun</creatorcontrib><creatorcontrib>Goto, Eriko</creatorcontrib><creatorcontrib>Goto, Tadashi</creatorcontrib><creatorcontrib>Yoshida, Hideo</creatorcontrib><creatorcontrib>Obi, Shuntaro</creatorcontrib><creatorcontrib>Sato, Shinpei</creatorcontrib><creatorcontrib>Kanai, Fumihiko</creatorcontrib><creatorcontrib>Yoshida, Haruhiko</creatorcontrib><creatorcontrib>Omata, Masao</creatorcontrib><collection>AGRIS</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>ComDisDome</collection><jtitle>Journal of gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tateishi, Ryosuke</au><au>Shiina, Shuichiro</au><au>Ohki, Takamasa</au><au>Sato, Takahisa</au><au>Masuzaki, Ryota</au><au>Imamura, Jun</au><au>Goto, Eriko</au><au>Goto, Tadashi</au><au>Yoshida, Hideo</au><au>Obi, Shuntaro</au><au>Sato, Shinpei</au><au>Kanai, Fumihiko</au><au>Yoshida, Haruhiko</au><au>Omata, Masao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment strategy for hepatocellular carcinoma: expanding the indications for radiofrequency ablation</atitle><jtitle>Journal of gastroenterology</jtitle><stitle>J Gastroenterol</stitle><addtitle>J Gastroenterol</addtitle><date>2009-01-01</date><risdate>2009</risdate><volume>44</volume><issue>19</issue><spage>142</spage><epage>146</epage><pages>142-146</pages><issn>0944-1174</issn><eissn>1435-5922</eissn><abstract>Background Radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is ordinarily indicated for those with three or fewer nodules, none of which exceeds 3 cm in diameter. This study investigated whether an apparent threshold exists in the diameter and number of nodules in terms of the prognosis of patients with HCC. Methods We enrolled 663 naïve patients with HCC who were treated with RFA at our hospital between 1999 and 2005. We analyzed the patients' prognosis using multivariate Cox proportional regression with the diameter and number of nodules as covariates and Child-Pugh class as a stratification factor. The diameter and number were categorized as <=2.0, 2.1-3.0, 3.1-4.0, 4.1-5.0, and >5 cm and 1, 2-3, 4-5, and >5, respectively. Results The adjusted hazard ratio of patients whose largest nodule was <=2.0, 2.1-3.0, 3.1-4.0, 4.1-5.0, and >5 cm was 1, 1.51, 2.56, 2.25, and 2.71, respectively. The adjusted hazard ratio of patients with one, two or three, four or five, and more than five nodules was 1, 1.35, 1.70, and 2.12, respectively. Therefore, patients with three or fewer nodules, none of which exceeds 5 cm in diameter, have a 5-year survival of 40%. Conclusions The prognosis of the patients worsened gradually as the diameter and number of nodules increased. No apparent threshold in the diameter or number of HCC nodules was detected. RFA can be applied beyond the conventional indications.</abstract><cop>Japan</cop><pub>Japan : Springer Japan</pub><pmid>19148809</pmid><doi>10.1007/s00535-008-2247-9</doi><tpages>5</tpages></addata></record> |
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| subjects | Abdominal Surgery Aged Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - therapy Catheter Ablation - methods Cohort Studies Colorectal Surgery Female Follow-Up Studies Gastroenterology Hepatology hepatoma Humans International Forum 2 Liver Neoplasms - mortality Liver Neoplasms - pathology Liver Neoplasms - therapy Male Medicine Medicine & Public Health Middle Aged Prognosis Proportional Hazards Models radiofrequency ablation Retrospective Studies Surgical Oncology survival analysis Survival Rate Treatment Outcome |
| title | Treatment strategy for hepatocellular carcinoma: expanding the indications for radiofrequency ablation |
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