Clinical significance and predictive factors of early massive recurrence after radiofrequency ablation in patients with a single small hepatocellular carcinoma.
- Author:
Ju Yeon CHO
1
;
Moon Seok CHOI
;
Gil Sun LEE
;
Won SOHN
;
Jemma AHN
;
Dong Hyun SINN
;
Geum Youn GWAK
;
Yong Han PAIK
;
Joon Hyeok LEE
;
Kwang Cheol KOH
;
Seung Woon PAIK
Author Information
- Publication Type:Original Article
- Keywords: Hepatocellular carcinoma; Radiofrequency ablation; Milan criteria; Early recurrence
- MeSH: Aged; Carcinoma, Hepatocellular/mortality/pathology/*surgery; Catheter Ablation; Female; Hepatitis B/complications; Hepatitis C/complications; Humans; Liver Neoplasms/mortality/pathology/*surgery; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Retrospective Studies; Risk Factors; Survival Rate; Treatment Outcome
- From:Clinical and Molecular Hepatology 2016;22(4):477-486
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Radiofrequency ablation (RFA) is one of the most frequently applied curative treatments in patients with a single small hepatocellular carcinoma (HCC). However, the clinical significance of and risk factors for early massive recurrence after RFA—a dreadful event limiting further curative treatment—have not been fully evaluated. METHODS: In total, 438 patients with a single HCC of size ≤3 cm who underwent percutaneous RFA as an initial treatment between 2006 and 2009 were included. Baseline patient characteristics, overall survival, predictive factors, and recurrence after RFA were evaluated. In addition, the incidence, impact on survival, and predictive factors of early massive recurrence, and initial recurrence beyond the Milan criteria within 2 years were also investigated. RESULTS: During the median follow-up of 68.4 months, recurrent HCC was confirmed in 302 (68.9%) patients, with early massive recurrence in 27 patients (6.2%). The 1-, 3-, and 5-year overall survival rates were 95.4%, 84.7%, and 81.8%, respectively, in patients with no recurrence, 99.6%, 86.4%, and 70.1% in patients with recurrence within the Milan criteria or late recurrence, and 92.6%, 46.5%, and 0.05% in patients with early massive recurrence. Multivariable analysis identified older age, Child-Pugh score B or C, and early massive recurrence as predictive of poor overall survival. A tumor size of ≥2 cm and tumor location adjacent to the colon were independent risk factors predictive of early massive recurrence. CONCLUSIONS: Early massive recurrence is independently predictive of poor overall survival after RFA in patients with a single small HCC. Tumors sized ≥2 cm and located adjacent to the colon appear to be independent risk factors for early massive recurrence.
