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Delay in treatment of early-stage hepatocellular carcinoma using radiofrequency ablation may impact survival of cirrhotic patients in a surveillance program

Authors

  • Wei-Ting Chen MD,

    1. Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
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  • Mark Lee Fernandes MD,

    Corresponding author
    1. Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
    2. Department of Gastroenterology and Hepatology, National University Hospital, National University Health System, Singapore, Singapore
    • Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University, 199, Tung Hwa North Road, Taipei, Taiwan. Fax: +886-3-3272236.===

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  • Chen-Chun Lin MD,

    1. Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
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  • Shi-Ming Lin MD

    Corresponding author
    1. Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
    • Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University, 199, Tung Hwa North Road, Taipei, Taiwan. Fax: +886-3-3272236.===

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  • Mark Lee Fernandes and Shi-Ming Lin contribute to this article equally.

Abstract

Background

The aim of this study was to evaluate the impact of the interval between diagnosis and treatment using radiofrequency (RF) ablation on the survival of patients with HCC detected through a surveillance program.

Methods

Between January 2004 and July 2007, 121 cirrhotic patients with 157 tumours detected through a surveillance program underwent RF ablation. A delay in treatment was defined as >5 weeks. The mean length of follow-up was 25 months (range 8–55 months). Cumulative survival of patients was analysed using the Kaplan–Meier method. Cox regression models were used to identify factors associated with patient survival.

Results

The 1-, 2- and 3-year survival rates were 92.5%, 78.5% and 67.2%. The independent predictors of poorer patient survival were time from diagnosis to treatment >5 weeks (pooled odds ratio [OR], 3.59; 95% confidence interval [CI], 1.58–8.18; P = 0.002), absence of complete ablation after the initial RF session (OR, 2.42; 95% CI 1.07–5.45; P = 0.033) and Child-Pugh B liver cirrhosis (OR, 2.46; 95% CI 1.06–5.70; P = 0.036).

Conclusions

Delay in the start of effective treatment for HCC using RF ablation may be associated with poorer patient survival. J. Surg. Oncol. 2011; 103:133–139. © 2010 Wiley-Liss, Inc.

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