Immediate and short-term results are important in validating a new procedure's efficacy. But to have legs, the procedure must be at least as good as the gold standard. In the case of radio-frequency ablation in patients with unresectable primary liver
Immediate and short-term results are important in validating a new procedure's efficacy. But to have legs, the procedure must be at least as good as the gold standard.
In the case of radio-frequency ablation in patients with unresectable primary liver cancer, three-year survival data show that it competes well with surgery's record.
"We in the field are very encouraged by recent data that suggest RFA can replace surgical resection," said Dr. Riccardo Lencioni, a diagnostic and interventional radiologist at the University of Pisa, Italy.
For the last several years, researchers at Verona University Medical School in Italy have successfully treated hepatocellular carcinomas 5 cm and smaller and have achieved good results in lesions larger than 5 cm with repeated treatment. Their breakthrough, however, occurred when they compared their three-year survival rates with those of surgery. They observed survival rates of up to 83% for patients with stable liver function.
The researchers included 53 cirrhotic patients with 65 hepatocellular carcinomas. Forty-one patients had single lesions and 12 had multiple. Eleven tumors were smaller than 3 cm, 43 were between 3 cm and 5 cm, and 11 were larger than 5 cm. A Rita Medical System RFA probe was used.
Survival rates were 87%, 63%, and 45% at 12, 24, and 36 months, respectively. When investigators divided patients into those with good liver function and mild cirrhosis and those with advanced cirrhosis, they found three-year survival rates of 83% and 31%, respectively. The study was published in the Nov.-Dec. issue of the journal Hepato-Gastroenterology.
"RFA is an important treatment option for the overwhelming majority of hepatocellular carcinoma patients who are not candidates for surgery," said lead investigator Dr. Alfredo Guglielmi, an interventional radiologist in the first department of general surgery at Verona University.
RFA may also represent an alternative to surgical resection, especially for high-risk patients, Guglielmi said.
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