The Clinical Analysis Of The Survival Time And The Prognostic Factors On 97 Hepatocellular Carcinoma (HCC) Cases Treated By Radiofrequency Ablation (RFA)

ObjectiveTo investigate the effectiveness, survival time and the prognostic factors of Radiofrequency ablation (RFA) on hepatocellular carcinoma(HCC), and also to analize the complications caused by RFA. Methods97 cases of HCC were treated by RFA in Sir Run Run Shaw hospital from May 2001 to Nov 2009. The change of alpha-fetoprotein (AFP) and liver function level before and after the treatment were analysed by t test.The retrospective study of a total of 10 factors which potentially affecting the outcome were analysed by Kaplan-Meier model. The Log-Rank test of univariate analysis and Cox regression model of multivariate analysis were analysed to identify the prognostic factors for survival time.ResultsThe AFP value before and after the treatment was (2035.11±503.34) ng/ml and (250.12±150.24) ng/ml respectively, with a significant difference between the two groups. The complete ablation rate of the tumor was 87.0%. The cumulative survival rates of RFA for HCC at 1 year,2 year,3 year and 5 year were 82.1%,70.1%,54.1%and 45.0%respectively. And the survival rates of small hepatocellular carcinoma (tumor size less than 3 cm) at 1,2,3 and 5 year achieved 88.1%,78.3%,60.8 and 51.3% respectively. The Log-Rank tests revealed that clinical stage, child-pugh grade, AFP value before RFA, diameter of mass, cirrhosis, vascular tumor embolus were related to survival time. Cox regression analysis indicated that AFP value before RFA,vascular tumor embolus and child-pugh grade were associated independently with survival time after RFA treatment. The mainly postoperative complications included fever, abdominal pain, skin burns, ascites, skin antrum and injury of pleural in costphrenic angle. No RFA-induced death was reported.ConclusionsRFA appears to be a safe and effective treatment, especially for small HCC which can achieve the therapeutic effects equal to the operation. It also becomes an effective alternative for advanced HCC and tumor recurrence. Protection of liver function and application of proper treatment strategy might improve the quality of life and prolong the survival.