In addition, we analyzed the relationship between the time interval from RFA of HCC to recurrence and prognosis. Between February 2001 and September 2007, 263 consecutive Japanese patients with small HCC were referred to our hospital for treatment. None had been previously treated for HCC, up to 3 nodules, each up to 3cm in diameter, absence of portal venous thrombosis and known extrahepatic metastases, and Child–Pugh class A or B liver cirrhosis. RFA treatment was selected in consideration of the site, size and number of tumors, functional reserve of the liver, tumor marker level, and the patient’s general status. Of the total number of patients, 89 (34%) were
treated with TACE, 69 (26%) with surgical resection, nine (3%) with PEI, six (2%) with liver transplantation Fostamatinib purchase (LT) and two (1%) with intraoperative RFA. The remaining 88 (34%) patients with 116 small HCC underwent Selleck Compound Library percutaneous RFA as a first-line treatment option and were included in the study population. Patient characteristics are given in Table 1. The 54 men and 34 women (age range, 45–80 years; median, 68 years) were followed for 14–90 months (median, 36 months). All patients underwent ultrasound-guided
percutaneous RFA, at which time 73 had Child–Pugh class A and 15 had Child–Pugh class B cirrhosis. Most patients (76%, 67/88) had a single tumor, 14 (16%) had two tumors and seven (8%) had three tumors. Maximum tumor diameter ranged 1–3 cm (median, 1.8 cm). Of the 88 patients, the HCC was 2 cm or less in 61 and more than 2 cm in the remaining 27.
The RFA procedure was explained fully to all patients, and informed consent was obtained. Despite the feasibility and availability of surgery, all patients voluntarily preferred ablation Idelalisib solubility dmso under informed consent. This study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki. Pretreatment imaging studies included abdominal ultrasonography (US), contrast-enhanced dynamic CT, and angiography combined with CT during arterial portography and hepatic arteriography. In 91 nodules, HCC was diagnosed based on the following classic imaging manifestations: (i) early enhancement at the arterial phase and hypoattenuation at the portal venous phase or at the equilibrium phase on contrast-enhanced dynamic CT; and (ii) hyperattenuation on CT during hepatic arteriography and hypoattenuation on CT during arterial portography.16–18 The remaining 25 nodules in 18 patients were diagnosed as HCC by pathological methods. All 116 nodules were percutaneously treated under US guidance, with all patients under conscious sedation with pentazocine (5–10 mg, Pentagin; Sankyo, Tokyo, Japan) and midazolam (1–4 mg, Dormicum; Astellas, Tokyo, Japan) administrated i.v. Vital signs were continuously monitored during the procedure.