Laparoscopic ablation of hepatocellular carcinoma in cirrhotic patients unsuitable for liver resection or percutaneous treatment: a cohort study

Autor: Michael, Zimmerman, Cillo, Umberto, Vitale, Alessandro, Davide, Dupuis, Stefano, Corso, Daniele, Neri, Francesco, D'Amico, Gringeri, Enrico, Farinati, Fabio, Valter, Vincenzi, Zanus, Giacomo
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Liver Cirrhosis
Male
Percutaneous
medicine.medical_treatment
liver tumors
lcsh:Medicine
Liver transplantation
Cohort Studies
HCC
Microwaves
lcsh:Science
Aged
80 and over
Multidisciplinary
Liver Diseases
Microwave ablation
Liver Neoplasms
Hepatitis C
Middle Aged
Ablation
Survival Rate
Treatment Outcome
Liver
Oncology
Catheter Ablation
Medicine
Female
alpha-Fetoproteins
Research Article
Adult
medicine.medical_specialty
Carcinoma
Hepatocellular
Clinical Research Design
Catheter ablation
Gastroenterology and Hepatology
Minimally Invasive Surgery
laparoscopic ablation
Laparoscopic Surgery
Hypertension
Portal
Gastrointestinal Tumors
medicine
Humans
Survival rate
Aged
Retrospective Studies
Ethanol
business.industry
lcsh:R
Cancers and Neoplasms
Perioperative
Hepatocellular Carcinoma
medicine.disease
Survival Analysis
Surgery
Liver Transplantation
Laparoscopy
lcsh:Q
business
Zdroj: PLoS ONE, Vol 8, Iss 2, p e57249 (2013)
PLoS ONE
ISSN: 1932-6203
Popis: The aim of this study was to demonstrate the safety and efficacy of laparoscopic ablation for cirrhotic HCC patients. Between January 2004 and December 2009, laparoscopic ablation was applied prospectively in 169 consecutive HCC patients (median age 62 years, 43% hepatitis C positive) considered ineligible for liver resection and/or percutaneous ablation. There was clinically relevant portal hypertension in 72% of cases. A significant proportion of subjects (50%) had multinodular tumors or nodules larger than 25 mm. The main ablation techniques used were radiofrequency in 103 patients (61%), microwave ablation in 8 (5%), and ethanol injection in 58 (34%). The primary endpoint was 3-year survival. There was no perioperative mortality. The overall morbidity rate was 25%. The median postoperative hospital stay was 3 days (range 1–19 days). Patients survived a median 33 months with a 3-year survival rate of 47%. Cox's multivariate analysis identified patient age, presence of diabetes, albumin ≤37 g/l, and alpha-fetoprotein >400 µg/l as significant preoperative predictors of survival, while the chance to undergo liver transplantation and postoperative ascites were the only independent postoperative predictor of survival. Laparoscopic ablation is a safe and effective therapeutic option for selected HCC patients ineligible for liver resection and/or percutaneous ablation.
Databáze: OpenAIRE
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