Early diffuse recurrence of hepatocellular carcinoma after percutaneous radiofrequency ablation: analysis of risk factors
Early diffuse recurrence of hepatocellular carcinoma after percutaneous radiofrequency ablation: analysis of risk factors
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DOI：
10.1007/s00330-012-2561-8
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发表时间：
2013-01-01
影响因子：
5.9
通讯作者：
Lim, Hyo Keun
中科院分区：
文献类型：
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作者：
Lee, Hee Young;Rhim, Hyunchul;Lim, Hyo Keun
为探讨影响肝细胞癌经皮超声引导射频消融(RFA)术后1年内早期弥漫性复发的危险因素，对146例经皮超声引导下经皮肝动脉化疗栓塞术(TACE)治疗后复发的肝癌患者中，选择23例早期弥漫性复发患者。早期弥漫性复发被定义为首次RFA后1年内三次或三次以上新复发的肝癌。作为对照组，我们选择了23名年龄和性别完全匹配的患者，这些患者在RFA后没有局部肿瘤进展或新的复发。为了分析风险因素，我们检查了患者因素和肿瘤因素。复发肿瘤发生在RFA后30至365天(中位时间203天)。单因素分析表明，较大的肿瘤大小和边界模糊是显著的危险因素(P<；0.05)。多因素分析表明，边界模糊是一个重要的危险因素(P<；0.05)。较大的肿瘤大小和边界模糊可能是RFA术后1年内肝细胞癌早期弥漫性复发的危险因素。有这种危险因素的肿瘤应该联合TACE治疗，以将治疗失败的可能性降至最低。欧洲中心超声引导射频消融术(RFA)被广泛用于肝细胞癌(HCC)。欧洲中心超声引导射频消融术(RFA)后早期弥漫性复发是一个重要的预后因素。
To evaluate the risk factors affecting early diffuse recurrence within 1 year of percutaneous ultrasound-guided radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC).Out of 146 patients who received transcatheter arterial chemoembolisation (TACE) for treatment of recurrent HCC after percutaneous ultrasound-guided RFA, we selected 23 patients with early diffuse recurrence. Early diffuse recurrence was defined as three or more new recurrent HCCs within 1 year of initial RFA. As a control group, we selected 23 patients, matched exactly for age and sex, in which there was no local tumour progression or new recurrence after RFA. To analyse the risk factors, we examined patient factors and tumour factors.Recurrent tumours occurred from 30 to 365 days after RFA (median time, 203 days). Univariate analysis indicated that larger tumour size and poorly defined margin were significant risk factors (P < 0.05). Multivariate analysis indicated that poorly defined margin was a significant risk factor (P < 0.05).Larger tumour size and poorly defined margin may be risk factors for early diffuse recurrence of HCC within 1 year of RFA. Tumours with such risk factors should be treated with a combination of TACE to minimise the potential for therapeutic failure.aEuro cent Ultrasound-guided radiofrequency ablation (RFA) is widely used for hepatocellular carcinoma (HCC).aEuro cent Early diffuse recurrence after RFA is an important prognostic factoraEuro cent The risk factors for recurrence are larger tumour size and poorly defined marginsaEuro cent Tumours with such risk factors should be treated with transarterial chemoembolisation.