OBJECTIVETo analyze the influencing factors affecting intrahepatic distant recurrence after radiofrequency ablation (RFA) for primary hepatic cancer.

METHODSEighty patients with primary hepatic tumors underwent RFA treatment between January 2002 and June 2005 were retrospectively analyzed. There were 49 males and 31 females aged from 34 to 84 years old. The tumor size was less than 5 cm and no more than 3 nodules. Univariate analysis and multivariate analysis were used to evaluate the risk factors for intrahepatic distant recurrence after RFA.

RESULTSThe cumulative rates of intrahepatic distant recurrence were 6.3%, 32.0%, and 67.3% at 1, 3, and 5 years, respectively. Univariate analysis revealed that pretreatment serum AFP level of >or= 50 microg/L (P = 0.029), decarboxy prothrombin (DCP) level of >or= 40 mAu/ml (P = 0.004), ablative margin of < 1 cm (P = 0.035), prothrombin time activity percent target of < 70% (P = 0.012), and poor Child-Pugh grade (P = 0.002) were related to intrahepatic distant recurrence. A multivariate analysis revealed that pretreatment serum AFP and DCP level, ablative margin and Child-Pugh grade were independent risk factors for intrahepatic distant recurrence.

CONCLUSIONSPrimary liver cancer patients with high serum AFP, DCP and poor Child-Pugh grade before RFA should be carefully followed up to monitor any intrahepatic distant recurrence. A sufficient ablative margin in RFA for primary liver cancer is required to prevent recurrence.