Role of Radiofrequency Ablation in Patients with Hepatocellular Carcinoma Who Undergo Prior Transarterial Chemoembolization: Long-Term Outcomes and Predictive Factors.
- Author:
Won SOHN
1
;
Moon Seok CHOI
;
Ju Yeon CHO
;
Geum Youn GWAK
;
Yong Han PAIK
;
Joon Hyeok LEE
;
Kwang Cheol KOH
;
Seung Woon PAIK
;
Byung Chul YOO
Author Information
- Publication Type:Original Article
- Keywords: Carcinoma, hepatocellular; Transarterial chemoembolization; Radiofrequency ablation; Outcome; Recurrence
- MeSH: Aged; Carcinoma, Hepatocellular/*mortality/*therapy; *Catheter Ablation; Chemoembolization, Therapeutic/mortality; Combined Modality Therapy/mortality; Female; Humans; Liver Neoplasms/*mortality/*therapy; Male; Middle Aged; Neoplasm Recurrence, Local/mortality; Survival Rate; Treatment Outcome; alpha-Fetoproteins/analysis
- From:Gut and Liver 2014;8(5):543-551
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: The role of radiofrequency ablation (RFA) remains uncertain in patients with viable hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE). METHODS: A total of 101 patients (April 2007 to August 2010) underwent RFA for residual or recurrent HCC after TACE. We analyzed their long-term outcomes and predictive factors. RESULTS: The overall survival rates after RFA were 93.1%, 65.4%, and 61.0% at 1, 3, and 5 years, respectively. Predictive factors for favorable overall survival were Child-Pugh class A (hazard ratio [HR], 3.45; p=0.001), serum alpha-fetoprotein (AFP) level <20 ng/mL (HR, 2.90; p=0.02), and recurrent tumors after the last TACE (HR, 3.14; p=0.007). The cumulative recurrence-free survival rate after RFA at 6 months was 50.1%. Predictive factors for early recurrence (within 6 months) were serum AFP level > or =20 ng/mL (HR, 3.02; p<0.001), tumor size > or =30 mm at RFA (HR, 2.90; p=0.005), and nonresponse to the last TACE (HR, 2.13; p=0.013). CONCLUSIONS: Patients with recurrent or residual HCC who undergo prior TACE show a favorable overall survival, although their tumors seem to recur early and frequently. While good liver function, a low serum AFP level, and recurrent tumors were independent predictive factors for a favorable overall survival, poor response to TACE, a high serum AFP level, and large tumors are associated with early recurrence.