Risk factors for recurrence of small hepatocellular carcinoma after long-term follow-up of percutaneous radiofrequency ablation

Radiofrequency ablation (RFA) as a local therapy for liver cancer is widely used. The study is to evaluate the therapeutic efficacy of RFA on hepatocellular carcinoma (HCC) and identify the risk factors for recurrence. Clinical records of 124 patients with 135 small HCC with percutaneous RFA as a first-line treatment modality were evaluated in Liver Cancer Institute, Zhongshan Hospital from October 2001 to December 2006. With a median follow-up period of 46 months after RFA therapy, the 1-, 2-, 3-, 4-, and 5-year cumulative survival rates and disease-free survival rates were 91, 70, 61, 48 and 40% and 64, 44, 31, 24 and 24%, respectively. The total recurrence and metastasis rates were 50 and 6.5%, respectively. Independent risk factors for recurrence after RFA included tumor with diameter more than 3 cm, located near the intrahepatic blood vessels, subcapsular locations and PT prolonged more than 3 s. Severe complications occurred in 2 cases (1.6%), including biliary tract hemorrhage and subphrenic effusion. RFA appears to be a safe and effective treatment for HCC. It will benefit the efficacy of RFA therapy if those risk factors are considered during the clinical practice.