Premium
Sequential multidisciplinary treatment of hepatocellular carcinoma: The role of surgery as rescue therapy for failure of percutaneous ablation therapies
Author(s) -
Portolani Nazario,
Baiocchi Gian Luca,
Coniglio Arianna,
Grazioli Luigi,
Frassi Eleonora,
Gheza Federico,
Giulini Stefano Maria
Publication year - 2009
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21375
Subject(s) - medicine , hepatocellular carcinoma , percutaneous , surgery , ablation , pathological , overall survival , hepatectomy , resection , survival rate
Background and Objectives The recurrence of hepatocellular carcinoma (HCC) after percutaneous ablation is poorly evaluated. Methods Thirty‐six cases of recurrence after percutaneous ablation (PA) (Group 1) are compared to those after surgery, treated with re‐resection (26 patients, Group 2) and PA (31 patients, Group 3). Results Recurrence was usually local after PA and distant after resection. Compared to Groups 2 and 3, local recurrences after PA were larger (4.2 vs. 2.3 cm) and more often invasive (43% vs. 10%). No different clinical/pathological aspects were noted in distant recurrences among the groups. After treatment the survival rate (1, 2, 3 and 5 years) was no different between the groups; in an intention‐to‐treat analysis of survival for local recurrences, survival was significantly lower in Group 1 (78%, 78%, 67% and 28%) than in Groups 2 and 3 (100%, 88%, 75% and 45%) ( P < 0.05). Conclusions PA and surgery can be sequentially employed for HCC. The type of primary treatment does not influence the features of distant liver recurrence, while local recurrence after PA often requires more extensive liver resection. J. Surg. Oncol. 2009;100:580–584. © 2009 Wiley‐Liss, Inc.