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Frequency of and Predictive Factors for Vascular Invasion after Radiofrequency Ablation for Hepatocellular Carcinoma

BACKGROUND: Vascular invasion in patients with hepatocellular carcinoma (HCC) is representative of advanced disease with an extremely poor prognosis. The detailed course of its development has not been fully elucidated. METHODS: We enrolled 1057 consecutive patients with HCC who had been treated wit...

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Autores principales: Asaoka, Yoshinari, Tateishi, Ryosuke, Nakagomi, Ryo, Kondo, Mayuko, Fujiwara, Naoto, Minami, Tatsuya, Sato, Masaya, Uchino, Koji, Enooku, Kenichiro, Nakagawa, Hayato, Kondo, Yuji, Shiina, Shuichiro, Yoshida, Haruhiko, Koike, Kazuhiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232383/
https://www.ncbi.nlm.nih.gov/pubmed/25397677
http://dx.doi.org/10.1371/journal.pone.0111662
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author Asaoka, Yoshinari
Tateishi, Ryosuke
Nakagomi, Ryo
Kondo, Mayuko
Fujiwara, Naoto
Minami, Tatsuya
Sato, Masaya
Uchino, Koji
Enooku, Kenichiro
Nakagawa, Hayato
Kondo, Yuji
Shiina, Shuichiro
Yoshida, Haruhiko
Koike, Kazuhiko
author_facet Asaoka, Yoshinari
Tateishi, Ryosuke
Nakagomi, Ryo
Kondo, Mayuko
Fujiwara, Naoto
Minami, Tatsuya
Sato, Masaya
Uchino, Koji
Enooku, Kenichiro
Nakagawa, Hayato
Kondo, Yuji
Shiina, Shuichiro
Yoshida, Haruhiko
Koike, Kazuhiko
author_sort Asaoka, Yoshinari
collection PubMed
description BACKGROUND: Vascular invasion in patients with hepatocellular carcinoma (HCC) is representative of advanced disease with an extremely poor prognosis. The detailed course of its development has not been fully elucidated. METHODS: We enrolled 1057 consecutive patients with HCC who had been treated with curative intent by radiofrequency ablation (RFA) as an initial therapy from 1999 to 2008 at our department. We analyzed the incidence rate of and predictive factors for vascular invasion. The survival rate after detection of vascular invasion was also analyzed. RESULTS: During a mean follow-up period of 4.5 years, 6075 nodules including primary and recurrent lesions were treated by RFA. Vascular invasion was observed in 97 patients. The rate of vascular invasion associated with site of original RFA procedure was 0.66% on a nodule basis. The incidence rates of vascular invasion on a patient basis at 1, 3, and 5 years were 1.1%, 5.9%, and 10.4%, respectively. Univariate analysis revealed that tumor size, tumor number, alpha-fetoprotein (AFP), des-gamma-carboxy prothrombin (DCP), and Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein were significant risk predictors of vascular invasion. In multivariate analysis, DCP was the most significant predictor for vascular invasion (compared with a DCP of ≤100 mAu/mL, the hazard ratio was 1.95 when DCP was 101–200 mAu/mL and 3.22 when DCP was >200 mAu/mL). The median survival time after development of vascular invasion was only 6 months. CONCLUSION: Vascular invasion occurs during the clinical course of patients initially treated with curative intent. High-risk patients may be identified using tumor markers.
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spelling pubmed-42323832014-11-26 Frequency of and Predictive Factors for Vascular Invasion after Radiofrequency Ablation for Hepatocellular Carcinoma Asaoka, Yoshinari Tateishi, Ryosuke Nakagomi, Ryo Kondo, Mayuko Fujiwara, Naoto Minami, Tatsuya Sato, Masaya Uchino, Koji Enooku, Kenichiro Nakagawa, Hayato Kondo, Yuji Shiina, Shuichiro Yoshida, Haruhiko Koike, Kazuhiko PLoS One Research Article BACKGROUND: Vascular invasion in patients with hepatocellular carcinoma (HCC) is representative of advanced disease with an extremely poor prognosis. The detailed course of its development has not been fully elucidated. METHODS: We enrolled 1057 consecutive patients with HCC who had been treated with curative intent by radiofrequency ablation (RFA) as an initial therapy from 1999 to 2008 at our department. We analyzed the incidence rate of and predictive factors for vascular invasion. The survival rate after detection of vascular invasion was also analyzed. RESULTS: During a mean follow-up period of 4.5 years, 6075 nodules including primary and recurrent lesions were treated by RFA. Vascular invasion was observed in 97 patients. The rate of vascular invasion associated with site of original RFA procedure was 0.66% on a nodule basis. The incidence rates of vascular invasion on a patient basis at 1, 3, and 5 years were 1.1%, 5.9%, and 10.4%, respectively. Univariate analysis revealed that tumor size, tumor number, alpha-fetoprotein (AFP), des-gamma-carboxy prothrombin (DCP), and Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein were significant risk predictors of vascular invasion. In multivariate analysis, DCP was the most significant predictor for vascular invasion (compared with a DCP of ≤100 mAu/mL, the hazard ratio was 1.95 when DCP was 101–200 mAu/mL and 3.22 when DCP was >200 mAu/mL). The median survival time after development of vascular invasion was only 6 months. CONCLUSION: Vascular invasion occurs during the clinical course of patients initially treated with curative intent. High-risk patients may be identified using tumor markers. Public Library of Science 2014-11-14 /pmc/articles/PMC4232383/ /pubmed/25397677 http://dx.doi.org/10.1371/journal.pone.0111662 Text en © 2014 Asaoka et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Asaoka, Yoshinari
Tateishi, Ryosuke
Nakagomi, Ryo
Kondo, Mayuko
Fujiwara, Naoto
Minami, Tatsuya
Sato, Masaya
Uchino, Koji
Enooku, Kenichiro
Nakagawa, Hayato
Kondo, Yuji
Shiina, Shuichiro
Yoshida, Haruhiko
Koike, Kazuhiko
Frequency of and Predictive Factors for Vascular Invasion after Radiofrequency Ablation for Hepatocellular Carcinoma
title Frequency of and Predictive Factors for Vascular Invasion after Radiofrequency Ablation for Hepatocellular Carcinoma
title_full Frequency of and Predictive Factors for Vascular Invasion after Radiofrequency Ablation for Hepatocellular Carcinoma
title_fullStr Frequency of and Predictive Factors for Vascular Invasion after Radiofrequency Ablation for Hepatocellular Carcinoma
title_full_unstemmed Frequency of and Predictive Factors for Vascular Invasion after Radiofrequency Ablation for Hepatocellular Carcinoma
title_short Frequency of and Predictive Factors for Vascular Invasion after Radiofrequency Ablation for Hepatocellular Carcinoma
title_sort frequency of and predictive factors for vascular invasion after radiofrequency ablation for hepatocellular carcinoma
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232383/
https://www.ncbi.nlm.nih.gov/pubmed/25397677
http://dx.doi.org/10.1371/journal.pone.0111662
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