Luciano Tarantino MD, Presenter: Nothing to Disclose

Francesco Sabbatino, Abstract Co-Author: Nothing to Disclose

Ignazio Maria Francesco Sordelli, Abstract Co-Author: Nothing to Disclose

Carmine Ripa, Abstract Co-Author: Nothing to Disclose

Marta Celiento, Abstract Co-Author: Nothing to Disclose

Giuseppe Cuccorese, Abstract Co-Author: Nothing to Disclose

Orsola Tambaro, Abstract Co-Author: Nothing to Disclose

Alberta Villanacci MD, Abstract Co-Author: Nothing to Disclose

Vincenzo Nocera, Abstract Co-Author: Nothing to Disclose

Michele Perrotta, Abstract Co-Author: Nothing to Disclose

Giovanni Iside, Abstract Co-Author: Nothing to Disclose

Pasquale Sperlongano, Abstract Co-Author: Nothing to Disclose

Analyze long-term results in a series of cirrhotics with Hepatocellular Carcinoma (HCC) strictly followed-up and repeatedly treated with loco-regional therapies for tumor recurrences.  

Series:  82 cirrhotics (45 ChildA and 37 ChildB class)with 107 HCC nodules (1-3 nodules per patient, diameter range: 1.2-6.0cm; mean diam.= 3.8cm). treated with Radiofrequency Ablation (RFA) . Selection criteria : a) less than 3 HCC nodules with diameter < 6 cm; b) High compliance to follow-up schedule (US every 3 months, CT every year, retreatment of recurrences when indicated); c) minimum follow-up=1 year. Recurrences were retreated with RFA and/or TACE and/or Surgery according with the new lesions features and patient’s conditions. Criteria for uneligibility to re-treatment : a) thrombosis of main portal vein, b) extensive HCC involvement of more than 3 hepatic segments, c) symptomatic extrahepatic disease, d) progression of cirrhosis to ChildC class.  Kaplan-Meier method and Cox hazard regression model were used for statistical analysis.  

During the median follow-up (30 months; range=9–84 months) from initial RFA, recurrence-rates at 1,2,3,5 years were 57.3%,71.8%,75.4%,85.3% respectively.  52/82 (63.4%) patients had distant recurrences, 9/82 (10.9%) local progression and 9/82 (10.9%) local and distant recurrences. Number of retreatment ranged 1 to 10 per patient (mean 2.56). 147/186 recurrent lesions in 66 patients,underwent retreatment with RFA(121) or Percutaneous Ethanol Injection (8) or TACE (7) or RFA+TACE (4) or Surgery+RFA (4) or Surgery (3 cases). In 39/186 cases the progression of the disease excluded any attempt of retreatment. Overall survival rates at 1,2,3,5 years were 95.1%,77.9%,67.8%,47.8% respectively. The median overall survival was 60 months. No statistically significant difference in survival  related to age, sex , AFP levels, and number of nodules (1vs>1) was observed. Smaller size of nodules (<3vs>3<5 vs>5cm), Child A class, a lower number of recurrences and a previous TACE among received treatments, were independent prognostic factors of longer survival.  

Intensive follow-up after initial RFA of HCC and repeated retreatment of recurrences results in high long term survival rates.

Patients highly compliant to follow-up after initial RFA of HCC in cirrhosis and repeated retreatment of recurrences results in high long-term survival rates

Tarantino, L, Sabbatino, F, Sordelli, I, Ripa, C, Celiento, M, Cuccorese, G, Tambaro, O, Villanacci, A, Nocera, V, Perrotta, M, Iside, G, Sperlongano, P, Repeated Loco-Regional Treatments: High Survival Rates in Cirrhotic Patients with Hepatocellular Carcinoma Highly Compliant to Scheduled Follow-up.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9003807.html