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10 In our study, after the first session, 75% of the nodules were completely necrotic, and the success rate was dependent on the size of the nodules: 94% for tumors Casein kinase 2 patient. Regarding complications of radiofrequency, Mulier et al16 conducted a meta-analysis of 82 studies involving 3,670 patients, which revealed a mortality rate of 0.5% and an overall complication rate of 8.9%. Forty-three Japanese centers17 identified comparable rates (mortality 0.3%, morbidity 8%). These values were higher in our series, with an overall complication rate of 10.9% and mortality rate of 2.2% (1/46 patients), most probably due to its small size. We can conclude that although RFA is considered to be a safe technique, it is not a risk-free technique and should be performed by experienced operators. In our study, RFA was performed under general anesthesia because it is a long and painful procedure for the patient, especially when there is more than one nodule (30% of our population), and when nodule��s location is subcapsular. With intubation, the breathing of the patient can be temporarily blocked, which helps the insertion of the electrode, especially when the nodule is located in the hepatic dome, and thus only accessible during forced inspiration. Moreover, a recent retrospective Trichostatin A clinical trial analysis suggested that treatment of small HCCs by RFA under general anesthesia is associated with a reduced risk of cancer recurrence relative to locoregional anesthesia, with no effect of anesthetic technique on overall survival detected.18 However, prospective, randomized trials are needed to confirm these results. Some long-term clinical trials have shown that RFA results in a long-term survival gain for patients with HCC. Since 2005, eight cohorts with large series of patients selleck products evaluating RFA showed survival rates at 5 years from 41% to 64% depending on the tumor size (Table 3). Overall survival at 1 year, estimated at 79.4% in our study, is comparable to the literature data: 76%�C97%. A study by Hu et al19 found a lower survival rate of 55.1%; however, their median tumor size was larger (6.1 cm). In our subgroup analysis comparing survival according to the etiology of cirrhosis, our results were inconsistent with those published by Giovannini et al in 2003,20 which found a better prognosis for radiofrequency treatment in patients with alcoholic cirrhosis: 2-year survival was statistically significantly different (57.7% vs 77.7%) for the alcoholic group. Nevertheless, our alcoholic group was constituted by patients who have more serious symptoms, with a higher Child�CPugh score and a higher number of lesions.
