Factors which predict the long-term outcome in patients with hepatocellular carcinoma treated with percutaneous laser ablation are not well established.
Dr Claudio Maurizio Pacella and colleagues from Italy prospectively analyzed treatment and survival parameters of 148 cirrhotic patients.
The patients had nonsurgical hepatocellular carcinoma, and had undergone percutaneous laser ablation at a single institution during an 11-year period.
The researchers observed single tumors in 87% of patients, and 2 to 3 nodules were seen in 13% of patients, for a total of 169 tumors.
| The 1-year cumulative survival rate was 89%|
|Journal of Hepatology|
The median overall time survival was 39 months.
The research team noted that the 1-, 2-, 3-, 4-, and 5-year cumulative survival rates were 89%, 75%, 52%, 43%, and 27%, respectively.
Using multiple regression analysis, the team found that tumor grading, and bilirubin levels 2.5mg/dl or less were independent predictors of survival.
The achievement of complete tumor ablation was also an independent predictor of survival.
An initial complete tumor ablation was the only factor associated with longer survival in patients with Child-Turcotte-Pugh class A cirrhosis.
Dr Pacella's team concluded, “A complete tumor ablation results in improved survival in all patients with nonsurgical hepatocellular carcinoma.”
“Ideal candidates for percutaneous laser ablation are those with a well-differentiated histology, and normal bilirubin levels.”