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Obesity did not diminish the efficacy of percutaneous ablation for hepatocellular carcinoma


Haruhiko Yoshida, MD, PhD., Department of Gastroenterology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
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Background: Overweight and hepatic steatosis can increase the risk of hepatocarcinogenesis. In addition, overweight may affect the treatment efficacy of ultrasound-guided percutaneous ablation. We evaluated the impact of overweight on the safety and efficacy of percutaneous ablation to hepatocellular carcinoma (HCC).

Methods: We enrolled 743 patients with naïve HCC who were treated by percutaneous ablation including ethanol injection, microwave coagulation, and radiofrequency ablation (RFA) between 1995 and 2003. Patients were divided into two groups by body mass index (BMI): 219 overweight patients with BMI>25 kg/m2 and 524 control patients with BMI≤25 kg/m2. The effects of BMI on complications of percutaneous ablation, HCC recurrence, and overall survival were analyzed, together with others including tumor and liver function-related factors.

Results: The overweight group required a significantly larger number of sessions by RFA (P=0.01). Major complications were identified in 8.7% in the overweight group and 7.6% in the control group (P=0.94). There was no significant difference in cumulative recurrence rate and local tumor-progression rate between the two groups (P=0.63 and 0.44). Cumulative survival rates at 1, 3, and 5 years were 95.4%, 75.7%, and 57.8%, respectively, in the overweight group and 94.1%, 78.0%, and 58.8% in the control group (P=0.99).

Conclusions: The results indicated that overweight did not increase complications nor affect HCC recurrence and overall survival. However, the number of sessions of RFA was significantly greater in overweight patients, suggesting that overweight was associated with minor technical difficulties.