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Prediction Model for Intrahepatic Distant Recurrence After Radiofrequency Ablation for Primary Hepatocellular Carcinoma 2 cm or Smaller

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Abstract

Background

Intrahepatic hepatocellular carcinoma (HCC) has a high recurrence rate after radiofrequency ablation (RFA). However, to date, no standalone predictive factors for intrahepatic distant recurrence after curative ablation have been reported.

Aims

The aim of this study was to investigate predictive factors for intrahepatic distant recurrence after curative treatment with RFA for HCCs.

Methods

This multicenter study consisted of 17 institutions that registered 821 patients. The risk factors for intrahepatic distant recurrence after complete ablation by RFA for primary HCC ≤ 2 cm in diameter were identified in a retrospectively collected training set (n = 636) and then validated in a prospectively collected validation set (n = 185).

Results

The cumulative intrahepatic distant and local recurrence rates (i.e., entire recurrence rate) in the training set were 23.6% and 53.7% at 1 and 3 years, respectively. The cumulative intrahepatic distant recurrence rates in the training set were 17.0% and 43.8% at 1 and 3 years, respectively. Multivariate analysis of the training set showed that tumor number and serum levels of α-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP) were independent risk factors for both entire recurrence and intrahepatic distant recurrence. Intrahepatic distant recurrence risk in both the training and validation cohorts was stratified using a scoring system with three factors: tumor number (single or multiple), AFP (< 10 ng/ml or ≥ 10 ng/ml), and DCP (< 50 mAU/ml or ≥ 50 mAU/ml).

Conclusion

The scoring system composed of tumor number, AFP, and DCP is useful for classifying the risk of intrahepatic distant recurrence after curative ablation for HCC.

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Abbreviations

AFP:

α-Fetoprotein

APRI:

Aspartate aminotransferase-to-platelet ratio index

AST:

Aspartate aminotransferase

ALT:

Alanine aminotransferase

BCLC:

Barcelona clinic liver cancer

CI:

Confidence interval

BMI:

Body mass index

DCP:

Des-γ-carboxy prothrombin

FIB-4:

Fibrosis-4

GGT:

Gamma-glutamyl transpeptidase

HCC:

Hepatocellular carcinoma

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

HR:

Hazard ratio

OLF:

Osaka Liver Forum

OS:

Overall survival

PT:

Prothrombin time

RFA:

Radiofrequency ablation

TACE:

Transcatheter arterial chemoembolization

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Acknowledgments

Other hospitals that attended the OLF were as follows: Osaka Police Hospital, Osaka General Medical Center, Osaka International Cancer Institute, Sumitomo Hospital, Japan Community Healthcare Organization Osaka Hospital, Minoh Municipal Hospital, Yao Municipal Hospital, Higashiosaka City Medical Center, Kansai Rosai Hospital, Osaka Rosai Hospital, Toyonaka Municipal Hospital, National Hospital Organization Osaka Medical Center, Itami City Hospital, NTT West Osaka Hospital, Ikeda Municipal Hospital, and Saiseikai Senri Hospital. The present study was supported by the Clinical Investigator’s Research Project of Osaka University Graduate School of Medicine.

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Author notes

  1. Atsuo Takigawa and Ryotaro Sakamori contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Atsuo Takigawa, Ryotaro Sakamori, Yuki Tahata, Teppei Yoshioka, Ryoko Yamada, Takahiro Kodama, Hayato Hikita, Takayuki Yakushijin, Tomohide Tatsumi & Tetsuo Takehara

  2. Osaka International Cancer Institute, Osaka, Osaka, Japan

    Kazuyoshi Ohkawa

  3. Osaka Rosai Hospital, Sakai, Osaka, Japan

    Naoki Hiramatsu

  4. National Hospital Organization Osaka Medical Center, Osaka, Osaka, Japan

    Eiji Mita

  5. Kansai Rosai Hospital, Amagasaki, Hyogo, Japan

    Hideki Hagiwara

  6. Japan Community Healthcare Organization Osaka Hospital, Osaka, Osaka, Japan

    Toshifmi Ito

  7. Ikeda Municipal Hospital, Ikeda, Osaka, Japan

    Yasuharu Imai

Authors
  1. Atsuo Takigawa
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Correspondence to Tetsuo Takehara.

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Takigawa, A., Sakamori, R., Tahata, Y. et al. Prediction Model for Intrahepatic Distant Recurrence After Radiofrequency Ablation for Primary Hepatocellular Carcinoma 2 cm or Smaller. Dig Dis Sci 67, 5704–5711 (2022). https://doi.org/10.1007/s10620-022-07455-2

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