Radiofrequency ablation for recurrent hepatocellular carcinoma in postresectional patients: prognostic factors analysis.

Background: Percutaneous ablation therapies can be used for recurrent hepatocellular carcinoma (HCC) in postresectional patients not eligible for repeat surgery.

Objective: To determine prognostic factors affecting the disease-free survival of postresectional patients after percutaneous ultrasound-guided radiofrequency ablation (RFA) for recurrent HCC.

Methods: From August 2003 to December 2009, patients who had received previous hepatectomy because of HCC and suffered from tumor recurrence were included. Among them, 82 patients who received initial percutaneous ultrasound-guided RFA were included. Various host, treatment, and therapeutic-related factors were analyzed.

Results: Eighty-two patients (64 men, mean age 64.27 years) were included. Sex (P=0.495), age (P=0.840), hepatitis marker (P=0.083), and Child-Pugh score (P=0.809) were not related to prognosis. Preresectional tumor number (P=0.502), recurrent tumor location (P=0.795), recurrent tumor number (P=0.533), pathology proved cirrhosis (P=0.889), and OKUDA stage of the primitive disease (P=0.865) were not related to prognosis, either. Survival rates were significantly related to the preresectional tumor size (P=0.008), microscopic portal vein invasion (P=0.001), recurrent tumor size (P<0.001), and preablation α-fetoprotein serum level (P=0.006). Ablation needle (P=0.373), ablation time (P=0.387), and postablation temperature (P=0.444) were not related to prognosis. Multivariate analysis revealed that microscopic portal vein invasion was the only factor that had a significant effect on patient survival.

Conclusions: In patients with postresectional HCC treated with percutaneous ultrasound-guided RFA for recurrent disease, those without microscopic portal vein invasion had a significantly higher probability of disease-free survival.