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Local Recurrence after Radiofrequency Ablation of Hepatocellular Carcinoma: Treatment Choice and Outcome

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background/aims

Radiofrequency ablation (RFA) has been proven effective for treating small hepatocellular carcinoma (HCC) nodules. However, post-RFA local recurrence is a major factor limiting prognosis. Up to now, there is no consensus on a standardized treatment strategy for these local recurrences. The aim of this study is to evaluate the outcomes of salvage treatments for RFA-related local recurrence.

Methods

From May 2008 to June 2013, a total of 112 patients with HCC were detected with local recurrence after RFA. Among them, 94 patients received sequential treatments in our hospital, including salvage resection (SR) (n = 24), salvage liver transplantation (n = 2), repeated RFA (n = 62), and transarterial chemoembolization (TACE) (n = 6). We evaluated the treatment outcomes of patients by salvage surgery (SS), RFA, and TACE.

Results

The median follow-up time was 32 months. After treatment, local recurrence was eradicated in 82 of 94 patients (87.2 %). The complete response (CR) rate in the RFA group was 90.3 % (56/62), while it was 100 % (26/26) in the SS group (P = 0.175) and 0 % (0/6) in the TACE group. When analysis confined to patients with CR, the 1- and 3-year disease-free survival (DFS) rates were 57.7 and 20.2 % in the SS group, and 41.7 and 28.6 % in the RFA group, respectively (P = 0.640). The 1- and 3-year overall survival (OS) rates were 93.3 and 69.1 % in the SS group, and 78.6 and 57.5 % in the RFA group, respectively (P = 0.251).

Conclusion

Repeated RFA is the first treatment choice for patients with post-RFA local recurrence. SS should be considered when RFA failed or is inapplicable.

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Conflicts of Interest

The authors have no conflict of interest to declare in connection with this study.

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Author notes

    Authors and Affiliations

    1. Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, 510080, People’s Republic of China

      Xiaoyan Xie, Baoxian Liu & Mingde Lu

    2. Division of Interventional Ultrasound, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, 510080, People’s Republic of China

      Chunlin Jiang, Ye Wang, Manxia Lin & Ming Kuang

    3. Department of Oncology, The First Affiliated Hospital, Sun Yat-sen Universi, 58 Zhongshan Road 2, Guangzhou, 510080, People’s Republic of China

      Zhengwei Peng

    4. Department of Liver Surgery, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, 510080, People’s Republic of China

      Wenjie Hu & Ming Kuang

    Authors
    1. Xiaoyan Xie
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    2. Chunlin Jiang
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    3. Zhengwei Peng
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    7. Manxia Lin
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    8. Mingde Lu
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    9. Ming Kuang
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    Corresponding author

    Correspondence to Ming Kuang.

    Additional information

    Xiaoyan Xie and Chunlin Jiang contributed equally to this work.

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    Xie, X., Jiang, C., Peng, Z. et al. Local Recurrence after Radiofrequency Ablation of Hepatocellular Carcinoma: Treatment Choice and Outcome. J Gastrointest Surg 19, 1466–1475 (2015). https://doi.org/10.1007/s11605-015-2850-z

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    • DOI: https://doi.org/10.1007/s11605-015-2850-z

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