Liver disease, virologic response predict survival in cirrhotic HCC patients after RFA
Virologic response and the severity of underlying liver disease predict long-term survival following radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) on cirrhosis, a recent study has shown.
Researchers enrolled 389 cirrhotic patients (median age 66 years; 76.6 percent male) who received RFA for HCC. Assessments were performed 1 month after RFA, every 3 months for the first 2 years and every 6 months for the following 2 years. Overall survival (OS), tumour recurrence and primary efficacy were among the study outcomes.
The primary efficacy rate of RFA was 86.1 percent; in 13.9 percent of the patients, more than one procedure was required to achieve complete ablation.
Median OS was determined to be 52.0 months; corresponding rates at 2, 5 and 10 years were 79.8 percent, 42.4 percent and 15.8 percent. Almost half of the deaths (49.5 percent) were related to HCC, while 24.0 percent of the deaths were due to liver disease, independent of HCC. The remaining 18.1 percent of deaths were due to nonliver-related causes.
Multivariate Cox proportional hazards regression models showed that age (hazard ratio [HR], 1.06; 95 percent CI, 1.04–1.08), a Child-Pugh score of B/C (HR, 2.75; 1.80–4.20) and gamma-glutamyl transferase levels >2N (HR, 1.53; 1.01–2.13) were all associated with an elevated risk of death. The same was true for alkaline phosphatase level >1.5N (HR, 2.68; 1.73–4.15).
In hepatitis C patients, OS was significantly longer in those who achieved a sustained virologic response relative to other patients (124.5 vs 49.2 months; p<0.001).