Influence of ablative margin on local tumor progression and survival in patients with HCC ≤4 cm after laser ablation.

Abstract

BACKGROUND:

Ablation of the normal hepatic parenchyma surrounding the tumor (ablative margin [AM]) is necessary to prevent local tumor progression.

PURPOSE:

To assess the prognostic value of the ablative margin in patients with HCC ≤4 cm treated with US-guided laser ablation.

MATERIAL AND METHODS:

A cohort of 116 patients (53 women and 63 men, age range 42-82 years) with 132 HCC nodules ≤4 cm completely ablated by US-guided laser ablation was retrospectively analyzed. Rates of local tumor progression were compared using different ablative margin cut-offs (≥2.5, 5.0, 7.5, and 10.0 mm). Survival probability curves were obtained with the Kaplan-Meier method.

RESULTS:

The mean period of follow-up was 42 months (range 3-114 months). Local tumor progression was identified in 24 out of 132 lesions (18%), with an average time to progression of 24 months (range 6-36 months). A significant difference in local tumor progression was observed only if the ablative margin was ≥7.5 mm (7% vs. 23%, P = 0.020). Survival curves of patients with or without an ablative margin ≥7.5 mm were not different (P = 0.665; mean survival time 43.8 ± 3.1 and 46.8 ± 6.1 for an AM < or ≥7.5 mm, respectively).

CONCLUSION:

An ablative margin ≥7.5 mm turned out to be useful in preventing local tumor progression but did not affect long-term survival in patients with HCC ≤4 cm treated with laser ablation.

• Authors: Giampiero Francica, Alesssandra Petrolati, Enrico Di Stasio, Sara Pacella, Roberto Stasi, Claudio Maurizio Pacella
• Journal: Acta radiologica (Stockholm, Sweden : 1987) (Acta Radiol) Vol. 53 Issue 4 Pg. 394-400 (May 01 2012) ISSN: 1600-0455 [Electronic] England
• PMID: 22393158 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Hepatocellular (diagnostic imaging, surgery)
• Chi-Square Distribution
• Disease Progression
• Female
• Humans
• Laser Therapy (methods)
• Liver Neoplasms (diagnostic imaging, surgery)
• Logistic Models
• Male
• Middle Aged
• Probability
• Retrospective Studies
• Statistics, Nonparametric
• Survival Rate
• Treatment Outcome
• Ultrasonography, Interventional