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Long-term outcomes of percutaneous cryoablation for patients with hepatocellular carcinoma within Milan criteria.

  • Author(s): Rong, Guanghua
  • Bai, Wenlin
  • Dong, Zheng
  • Wang, Chunping
  • Lu, Yinying
  • Zeng, Zhen
  • Qu, Jianhui
  • Lou, Min
  • Wang, Hong
  • Gao, Xudong
  • Chang, Xiujuan
  • An, Linjing
  • Li, Hongyan
  • Chen, Yan
  • Hu, Ke-Qin
  • Yang, Yongping
  • et al.
Abstract

BACKGROUND:Accumulating evidences have suggested that percutaneous cryoablation could be a valuable alternative ablation therapy for HCC but there has been no large cohort-based analysis on its long-term outcomes. METHODS:A series of 866 patients with Child-Pugh class A-B cirrhosis and HCC within Milan criteria who underwent percutaneous cryoablation was long-term followed. The safety, efficacy, 5-year survival, and prognostic factors of percutaneous cryoablation in the treatment of HCC were analyzed. RESULTS:A total of 1197 HCC lesions were ablated with 1401 cryoablation sessions. Complete response (CR) was achieved in 1163 (97.2%) lesions and 832 (96.1%) patients with 34 (2.8%) major complications, but no treatment-related mortality. After a median of 30.9 months follow-up, 502 (60.3%) patients who achieved CR developed different types of recurrence. The cumulative local tumor recurrence rate was 24.2% at 5-years. Multiple tumor lesions, tumor size > 3 cm, and repeated ablation of same lesion were independent risk factors associated with local recurrence. The 5-year overall survival (OS) rates were 59.5%. Age < 36 years, HCC family history, baseline hepatitis B virus DNA >106 copies/ml, and three HCC lesions were independently and significantly negative predictors to the post-cryoablation OS. CONCLUSIONS:Percutaneous cryoablation is an effective therapy for patients with HCC within Milan criteria, with comparable efficacy, safety and long-term survival to the reported outcomes of radiofrequency ablation.

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