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Percutaneous Radiofrequency Ablation for Recurrent Hepatocellular Carcinoma After Hepatectomy: Long-term Results and Prognostic Factors

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Abstract

Background

We evaluated the long-term survival results and safety of percutaneous radiofrequency ablation (RFA) for recurrent hepatocellular carcinoma (HCC) after hepatectomy, and assessed the prognostic factors that can influence its long-term therapeutic results.

Methods

One hundred and two patients, who had 119 recurrent HCC in their livers, underwent ultrasound-guided percutaneous RFA. All the patients had a history of hepatic resection as a first-line treatment modality for HCC. The mean diameter of the recurrent tumors was 2.0 cm (range, 0.8–5.0 cm). We evaluated the effectiveness rates, local tumor progression rates, survival rates, and complications. We also assessed the prognostic factors of the survival rates by using Cox proportional hazard models.

Results

The primary effectiveness rate was 93.3% (111 of 119). The cumulative rates of local tumor progression at 1, 3, and 5 years were 6.0, 8.6, and 11.9%, respectively. The cumulative survival rates at 1, 2, 3, 4, and 5 years were 93.9, 83.7, 65.7, 56.6, and 51.6%, respectively. Patients with a lower serum α-fetoprotein (AFP) level (≤100 μg/L) before RFA or with small resected tumors (≤5 cm) demonstrated better survival results (P < .05). There was only one major complication (liver abscess, 1.0% per treatment) during the follow-up period. There were no procedure-related deaths.

Conclusions

Percutaneous RFA is an effective and safe treatment modality for intrahepatic recurrent HCC after hepatectomy. Serum AFP level before RFA and resected tumor size were significant prognostic predictors of long-term survival.

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AcknowledgEments

This study was supported by a grant from the Samsung Medical Center Clinical Research Development Program. We thank Kyong Hee Lee at Samsung Biomedical Research Institute for the data collection.

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Authors and Affiliations

  1. Departments of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul, 135-710, Korea

    Dongil Choi MD, Hyo K. Lim MD, Hyunchul Rhim MD & Young-sun Kim MD

  2. Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul, 135-710, Korea

    Byung Chul Yoo MD & Seung Woon Paik MD

  3. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul, 135-710, Korea

    Jae-Won Joh MD

  4. Department of Diagnostic Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul, 135-710, Korea

    Cheol Keun Park MD

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  1. Dongil Choi MD
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Correspondence to Hyo K. Lim MD.

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Choi, D., Lim, H.K., Rhim, H. et al. Percutaneous Radiofrequency Ablation for Recurrent Hepatocellular Carcinoma After Hepatectomy: Long-term Results and Prognostic Factors. Ann Surg Oncol 14, 2319–2329 (2007). https://doi.org/10.1245/s10434-006-9220-8

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  • DOI: https://doi.org/10.1245/s10434-006-9220-8

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