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 |
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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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