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Erschienen in: Annals of Surgical Oncology 4/2012

01.04.2012 | Hepatobiliary Tumors

High Serum Hyaluronic Acid and HBV Viral Load are Main Prognostic Factors of Local Recurrence after Complete Radiofrequency Ablation of Hepatitis B-Related Small Hepatocellular Carcinoma

verfasst von: Feng Xia, MD, PhD, Eric C. H. Lai, MBChB, FRACS, Wan-Yee Lau, MD, FRCS, FACS, FRACS(Hon), Kuansheng Ma, MD, PhD, Xiaowu Li, MD, PhD, Ping Bie, MD, PhD, Cheng Qian, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 4/2012

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Abstract

Purpose

The risk factors of local recurrence after complete radiofrequency ablation (RFA) of hepatitis B-related small hepatocellular carcinoma (HCC), ≤3 cm, remains to be clarified. In this study, we evaluated the potential prognostic factors that affect recurrence.

Methods

A total of 152 consecutive patients with small HCC who had undergone complete RFA were retrospectively studied. The risk factors of local recurrence and their impact on survivals of patients were analyzed.

Results

After a median follow-up of 35 months, intrahepatic recurrence occurred in 67 patients (44.1%). On univariate analysis, HBV DNA, hyaluronic acid, AFP, MELD score, and precollagen III were independent risk factors for recurrence. On multivariate analysis, HBV DNA and hyaluronic acid were independent risk factors for recurrence. The cumulative 1-, 3-, and 5-year disease-free survival rates were 86.8%, 41.2%, and 22.8% in the high viral load group and 96.4%, 65.8%, and 36.7% in the low viral load group, respectively. The difference between the two groups was significant (P = 0.003). The cumulative 1-, 3-, and 5-year disease-free survival rates were 87.2%, 42%, and 27.2% in the abnormal hyaluronic acid group and 94.9%, 63.5%, and 33.9% in the normal group, respectively. The difference between the two groups also was significant (P = 0.011). Multivariate analysis identified MELD score as the only independent risk factor for overall survival of all patients.

Conclusions

High serum hyaluronic acid and HBV viral load are main prognostic factors of local recurrence after complete radiofrequency ablation of hepatitis B-related small HCC.
Literatur
1.
Zurück zum Zitat El-Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology. 2007;132:2557–76.PubMedCrossRef El-Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology. 2007;132:2557–76.PubMedCrossRef
2.
Zurück zum Zitat Lau WY, Lai EC. Hepatocellular carcinoma: current management and recent advances. Hepatobiliary Pancreat Dis Int. 2008;7:237–57.PubMed Lau WY, Lai EC. Hepatocellular carcinoma: current management and recent advances. Hepatobiliary Pancreat Dis Int. 2008;7:237–57.PubMed
3.
Zurück zum Zitat Lau WY, Lai EC. The current role of radiofrequency ablation in the management of hepatocellular carcinoma: a systematic review. Ann Surg. 2009;249:20–5.PubMedCrossRef Lau WY, Lai EC. The current role of radiofrequency ablation in the management of hepatocellular carcinoma: a systematic review. Ann Surg. 2009;249:20–5.PubMedCrossRef
4.
Zurück zum Zitat Livraghi T, Meloni F, Di Stasi M, Rolle E, Solbiati L, Tinelli C, et al. Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: is resection still the treatment of choice? Hepatology. 2008;47:82–9.PubMedCrossRef Livraghi T, Meloni F, Di Stasi M, Rolle E, Solbiati L, Tinelli C, et al. Sustained complete response and complications rates after radiofrequency ablation of very early hepatocellular carcinoma in cirrhosis: is resection still the treatment of choice? Hepatology. 2008;47:82–9.PubMedCrossRef
5.
Zurück zum Zitat Chen MS, Li JQ, Zheng Y, Guo RP, Liang HH, Zhang YQ, et al. A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma. Ann Surg. 2006;243:321–8.PubMedCrossRef Chen MS, Li JQ, Zheng Y, Guo RP, Liang HH, Zhang YQ, et al. A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma. Ann Surg. 2006;243:321–8.PubMedCrossRef
6.
Zurück zum Zitat Harrison LE, Koneru B, Baramipour P, Fisher A, Barone A, Wilson D, et al. Locoregional recurrences are frequent after radiofrequency ablation for hepatocellular carcinoma [see comment]. J Am Coll Surg. 2003;197:759–64.PubMedCrossRef Harrison LE, Koneru B, Baramipour P, Fisher A, Barone A, Wilson D, et al. Locoregional recurrences are frequent after radiofrequency ablation for hepatocellular carcinoma [see comment]. J Am Coll Surg. 2003;197:759–64.PubMedCrossRef
7.
Zurück zum Zitat Parise ER, Oliveira AC, Figueiredo-Mendes C, Lanzoni V, Martins J, Nader H, Ferraz ML. Noninvasive serum markers in the diagnosis of structural liver damage in chronic hepatitis C virus infection. Liver Int. 2006;26(9):1095–9.PubMedCrossRef Parise ER, Oliveira AC, Figueiredo-Mendes C, Lanzoni V, Martins J, Nader H, Ferraz ML. Noninvasive serum markers in the diagnosis of structural liver damage in chronic hepatitis C virus infection. Liver Int. 2006;26(9):1095–9.PubMedCrossRef
8.
Zurück zum Zitat Saitou Y, Shiraki K, Yamanaka Y, Yamaguchi Y, Kawakita T, Yamamoto N, Sugimoto K, Murata K, Nakano T, Noninvasive estimation of liver fibrosis and response to interferon therapy by a serum fibrogenesis marker, YKL-40, in patients with HCV-associated liver disease. World J Gastroenterol. 2005;11(4):476–81.PubMed Saitou Y, Shiraki K, Yamanaka Y, Yamaguchi Y, Kawakita T, Yamamoto N, Sugimoto K, Murata K, Nakano T, Noninvasive estimation of liver fibrosis and response to interferon therapy by a serum fibrogenesis marker, YKL-40, in patients with HCV-associated liver disease. World J Gastroenterol. 2005;11(4):476–81.PubMed
9.
Zurück zum Zitat Miao RY, Zhao HT, Yang HY, Mao YL, Lu X, Zhao Y, Liu CN, Zhong SX, Sang XT, Huang JF. Postoperative adjuvant antiviral therapy for hepatitis B/C virus-related hepatocellular carcinoma: a meta-analysis. World J Gastroenterol. 2010;16(23):2931–42.PubMedCrossRef Miao RY, Zhao HT, Yang HY, Mao YL, Lu X, Zhao Y, Liu CN, Zhong SX, Sang XT, Huang JF. Postoperative adjuvant antiviral therapy for hepatitis B/C virus-related hepatocellular carcinoma: a meta-analysis. World J Gastroenterol. 2010;16(23):2931–42.PubMedCrossRef
10.
Zurück zum Zitat Chen CJ, Yang HI, Su J, Jen CL, You SL, Lu SN, et al. Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. JAMA. 2006;295:65–73.PubMedCrossRef Chen CJ, Yang HI, Su J, Jen CL, You SL, Lu SN, et al. Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. JAMA. 2006;295:65–73.PubMedCrossRef
11.
Zurück zum Zitat Sun HC, Zhang W, Qin LX, Zhang BH, Ye QH, Wang L, et al. Positive serum hepatitis B e antigen is associated with higher risk of early recurrence and poorer survival in patients after curative resection of hepatitis B-related hepatocellular carcinoma. J Hepatol. 2007;47(5):684–90.PubMedCrossRef Sun HC, Zhang W, Qin LX, Zhang BH, Ye QH, Wang L, et al. Positive serum hepatitis B e antigen is associated with higher risk of early recurrence and poorer survival in patients after curative resection of hepatitis B-related hepatocellular carcinoma. J Hepatol. 2007;47(5):684–90.PubMedCrossRef
12.
Zurück zum Zitat Lam VW, Ng KK, Chok KS, Cheung TT, Yuen J, Tung H, et al. Risk factors and prognostic factors of local recurrence after radiofrequency ablation of hepatocellular carcinoma. J Am Coll Surg. 2008;207(1):20–9.PubMedCrossRef Lam VW, Ng KK, Chok KS, Cheung TT, Yuen J, Tung H, et al. Risk factors and prognostic factors of local recurrence after radiofrequency ablation of hepatocellular carcinoma. J Am Coll Surg. 2008;207(1):20–9.PubMedCrossRef
13.
Zurück zum Zitat Sakka SG, Koeck H, Meier-Hellmann A. Measurement of indocyanine green plasma disappearance rate by two different dosages. Intensive Care Med. 2004;30:506–9.PubMedCrossRef Sakka SG, Koeck H, Meier-Hellmann A. Measurement of indocyanine green plasma disappearance rate by two different dosages. Intensive Care Med. 2004;30:506–9.PubMedCrossRef
14.
Zurück zum Zitat Hsu KY, Chau GY, Lui WY, Tsay SH, King KL, Wu CW. Predicting morbidity and mortality after hepatic resection in patients with hepatocellular carcinoma: the role of Model for End-Stage Liver Disease score. World J Surg. 2009;33(11):2412–9.PubMedCrossRef Hsu KY, Chau GY, Lui WY, Tsay SH, King KL, Wu CW. Predicting morbidity and mortality after hepatic resection in patients with hepatocellular carcinoma: the role of Model for End-Stage Liver Disease score. World J Surg. 2009;33(11):2412–9.PubMedCrossRef
15.
Zurück zum Zitat Yeo W, Mo FK, Chan SL, Leung NW, Hui P, Lam WY, Mok TS, Lam KC, Ho WM, Koh J, Tang JW, Chan AT, Chan PK. Hepatitis B viral load predicts survival of HCC patients undergoing systemic chemotherapy. Hepatology. 2007;45(6):1382–9.PubMedCrossRef Yeo W, Mo FK, Chan SL, Leung NW, Hui P, Lam WY, Mok TS, Lam KC, Ho WM, Koh J, Tang JW, Chan AT, Chan PK. Hepatitis B viral load predicts survival of HCC patients undergoing systemic chemotherapy. Hepatology. 2007;45(6):1382–9.PubMedCrossRef
16.
Zurück zum Zitat Sala M, Llovet JM, Vilana R, Bianchi L, Solé M, Ayuso C, et al. Barcelona Clínic Liver Cancer Group. Initial response to percutaneous ablation predicts survival in patients with hepatocellular carcinoma. Hepatology. 2004;40:1352–60.PubMedCrossRef Sala M, Llovet JM, Vilana R, Bianchi L, Solé M, Ayuso C, et al. Barcelona Clínic Liver Cancer Group. Initial response to percutaneous ablation predicts survival in patients with hepatocellular carcinoma. Hepatology. 2004;40:1352–60.PubMedCrossRef
17.
Zurück zum Zitat Takahashi S, Kudo M, Chung H, Inoue T, Ishikawa E, Kitai S, et al. Initial treatment response is essential to improve survival in patients with hepatocellular carcinoma who underwent curative radiofrequency ablation therapy. Oncology. 2007;72(Suppl):98–103.PubMedCrossRef Takahashi S, Kudo M, Chung H, Inoue T, Ishikawa E, Kitai S, et al. Initial treatment response is essential to improve survival in patients with hepatocellular carcinoma who underwent curative radiofrequency ablation therapy. Oncology. 2007;72(Suppl):98–103.PubMedCrossRef
18.
Zurück zum Zitat Guglielmi A, Ruzzenente A, Sandri M, Pachera S, Pedrazzani C, Tasselli S, et al. Radiofrequency ablation for hepatocellular carcinoma in cirrhotic patients: prognostic factors for survival. J Gastrointest Surg. 2007;11:143–9.PubMedCrossRef Guglielmi A, Ruzzenente A, Sandri M, Pachera S, Pedrazzani C, Tasselli S, et al. Radiofrequency ablation for hepatocellular carcinoma in cirrhotic patients: prognostic factors for survival. J Gastrointest Surg. 2007;11:143–9.PubMedCrossRef
19.
Zurück zum Zitat Liaw YF, Sung JJ, Chow WC, Farrell G, Lee CZ, Yuen H, et al. Cirrhosis Asian Lamivudine Multicentre Study Group. Lamivudine for patients with chronic hepatitis B and advanced liver disease. N Engl J Med. 2004;351:1521–31.PubMedCrossRef Liaw YF, Sung JJ, Chow WC, Farrell G, Lee CZ, Yuen H, et al. Cirrhosis Asian Lamivudine Multicentre Study Group. Lamivudine for patients with chronic hepatitis B and advanced liver disease. N Engl J Med. 2004;351:1521–31.PubMedCrossRef
20.
Zurück zum Zitat Goto T, Yoshida H, Tateishi R, Enooku K, Goto E, Sato T, et al. Influence of serum HBV DNA load on recurrence of hepatocellular carcinoma after treatment with percutaneous radiofrequency ablation. Hepatol Int. 2011 Jan 25. [Epub ahead of print] PMID:21484129. Goto T, Yoshida H, Tateishi R, Enooku K, Goto E, Sato T, et al. Influence of serum HBV DNA load on recurrence of hepatocellular carcinoma after treatment with percutaneous radiofrequency ablation. Hepatol Int. 2011 Jan 25. [Epub ahead of print] PMID:21484129.
21.
Zurück zum Zitat Bruix J, Castells A, Bosch J, Feu F, Fuster J, Garcia-Pagan JC, et al. Surgical resection of hepatocellular carcinoma in cirrhotic patients: prognostic value of preoperative portal pressure. Gastroenterology. 1996;111:1018–22.PubMedCrossRef Bruix J, Castells A, Bosch J, Feu F, Fuster J, Garcia-Pagan JC, et al. Surgical resection of hepatocellular carcinoma in cirrhotic patients: prognostic value of preoperative portal pressure. Gastroenterology. 1996;111:1018–22.PubMedCrossRef
22.
Zurück zum Zitat Park YK, Kim BW, Wang HJ, Kim MW. Hepatic resection for hepatocellular carcinoma meeting Milan criteria in Child-Turcotte-Pugh class a patients with cirrhosis. Transplant Proc. 2009;41:1691–7.PubMedCrossRef Park YK, Kim BW, Wang HJ, Kim MW. Hepatic resection for hepatocellular carcinoma meeting Milan criteria in Child-Turcotte-Pugh class a patients with cirrhosis. Transplant Proc. 2009;41:1691–7.PubMedCrossRef
23.
Zurück zum Zitat Guechot J, Loria A, Serfaty L, Giral P, Giboudeau J, Poupon R. Serum hyaluronan as a marker of liver fibrosis in chronic viral hepatitis C: effect of alpha-interferon therapy. J Hepatol. 1995;22:22–6.PubMedCrossRef Guechot J, Loria A, Serfaty L, Giral P, Giboudeau J, Poupon R. Serum hyaluronan as a marker of liver fibrosis in chronic viral hepatitis C: effect of alpha-interferon therapy. J Hepatol. 1995;22:22–6.PubMedCrossRef
24.
Zurück zum Zitat Guechot J, Laudat A, Loria A, Serfaty L, Poupon R, Giboudeau J. Diagnostic accuracy of hyaluronan and type III procollagen aminoterminal peptide serum assays as markers of liver fibrosis in chronic viral hepatitis C evaluated by ROC curve analysis. Clin Chem. 1996;42:558–63.PubMed Guechot J, Laudat A, Loria A, Serfaty L, Poupon R, Giboudeau J. Diagnostic accuracy of hyaluronan and type III procollagen aminoterminal peptide serum assays as markers of liver fibrosis in chronic viral hepatitis C evaluated by ROC curve analysis. Clin Chem. 1996;42:558–63.PubMed
25.
Zurück zum Zitat Parise ER, Oliveira AC, Figueiredo-Mendes C, Lanzoni V, Martins J, Nader H, et al. Noninvasive serum markers in the diagnosis of structural liver damage in chronic hepatitis C virus infection. Liver Int. 2006;26:1095–9.PubMedCrossRef Parise ER, Oliveira AC, Figueiredo-Mendes C, Lanzoni V, Martins J, Nader H, et al. Noninvasive serum markers in the diagnosis of structural liver damage in chronic hepatitis C virus infection. Liver Int. 2006;26:1095–9.PubMedCrossRef
26.
Zurück zum Zitat Saitou Y, Shiraki K, Yamanaka Y, Yamaguchi Y, Kawakita T, Yamamoto N, et al. Noninvasive estimation of liver fibrosis and response to interferon therapy by a serum fibrogenesis marker, YKL-40, in patients with HCV-associated liver disease. World J Gastroenterol. 2005;11:476–81.PubMed Saitou Y, Shiraki K, Yamanaka Y, Yamaguchi Y, Kawakita T, Yamamoto N, et al. Noninvasive estimation of liver fibrosis and response to interferon therapy by a serum fibrogenesis marker, YKL-40, in patients with HCV-associated liver disease. World J Gastroenterol. 2005;11:476–81.PubMed
Metadaten
Titel
High Serum Hyaluronic Acid and HBV Viral Load are Main Prognostic Factors of Local Recurrence after Complete Radiofrequency Ablation of Hepatitis B-Related Small Hepatocellular Carcinoma
verfasst von
Feng Xia, MD, PhD
Eric C. H. Lai, MBChB, FRACS
Wan-Yee Lau, MD, FRCS, FACS, FRACS(Hon)
Kuansheng Ma, MD, PhD
Xiaowu Li, MD, PhD
Ping Bie, MD, PhD
Cheng Qian, MD, PhD
Publikationsdatum
01.04.2012
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe 4/2012
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-2042-3

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