In a previous study, Dr Hiroki Nishikawa from Japan classified the radicality of percutaneous radiofrequency ablation therapy for single hepatocellular carcinoma according to the extent of the ablated margin.
The team demonstrated that this grading system was useful for predicting local tumor progression after radiofrequency ablation.
The team measured the overall survival, the recurrence free survival, and the distant recurrence rate for each R grade, and to examine the relationship between clinical outcome and R grading.
This study involved 368 patients with solitary hepatocellular carcinoma who had undergone radiofrequency ablation.
|The calculated pooled gastric cancer incidence-rate was about 0.3% per person-years|
|Journal of Gastroenterology|
The mean tumor diameter was 2 cm.
The researchers calculated the post-radiofrequency ablation cumulative overall survival, recurrence free survival, and distant recurrence rate for each R grade, and analyzed the factors contributing to clinical outcomes.
Significant factors included tumor size more than 2 cm, serum albumin more than 3.5 g/dL, prothrombin time greater than 70 %, and hepatocellular carcinoma recurrence within 1 year.
Additional factors included R grading in overall survival, cause of liver disease, gamma glutamyl transpeptidase greater than 80 IU/L, platelet count more than 10 × 104/mm3, and R grading in radiofrequency ablation, gamma glutamyl transpeptidase more than 80 IU/L, platelet count more than 10 × 104/mm3, and R grading in distant recurrence.
In patients with sufficient Lipiodol accumulation, very similar results were obtained.
The researchers found that in patients with grade A and B, R grade was not a significant independent factor linked to overall survival, although grade A patients had lower local tumor progression rate.
Dr Nishikawa's team concludes, "Our proposed R grading system appears to be useful for predicting clinical outcomes after radiofrequency ablation."