Role of Radiofrequency Ablation in Patients with Hepatocellular Carcinoma Who Undergo Prior Transarterial Chemoembolization: Long-Term Outcomes and Predictive Factors
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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 August2010) underwent RFA for residual or recurrent HCC afterTACE. We analyzed their long-term outcomes and predictivefactors. Results: The overall survival rates after RFA were93.1%, 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), serumα-fetoprotein (AFP) level <20 ng/mL (HR, 2.90; p=0.02), andrecurrent tumors after the last TACE (HR, 3.14; p=0.007). The cumulative recurrence-free survival rate after RFA at 6months was 50.1%. Predictive factors for early recurrence(within 6 months) were serum AFP level ≥20 ng/mL (HR, 3.02;p<0.001), tumor size ≥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 undergoprior TACE show a favorable overall survival, althoughtheir tumors seem to recur early and frequently. While goodliver function, a low serum AFP level, and recurrent tumorswere independent predictive factors for a favorable overallsurvival, poor response to TACE, a high serum AFP level, andlarge tumors are associated with early recurrence.
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 August2010) underwent RFA for residual or recurrent HCC afterTACE. We analyzed their long-term outcomes and predictivefactors. Results: The overall survival rates after RFA were93.1%, 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), serumα-fetoprotein (AFP) level <20 ng/mL (HR, 2.90; p=0.02), andrecurrent tumors after the last TACE (HR, 3.14; p=0.007). The cumulative recurrence-free survival rate after RFA at 6months was 50.1%. Predictive factors for early recurrence(within 6 months) were serum AFP level ≥20 ng/mL (HR, 3.02;p<0.001), tumor size ≥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 undergoprior TACE show a favorable overall survival, althoughtheir tumors seem to recur early and frequently. While goodliver function, a low serum AFP level, and recurrent tumorswere independent predictive factors for a favorable overallsurvival, poor response to TACE, a high serum AFP level, andlarge tumors are associated with early recurrence.
참고문헌 (17)
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