Correlation between early recurrence and long-term prognosis in patients with hepatocellular carcinoma after local thermal ablation

Objective To investigate the effect of early progression on overall survival in patients with hepatocellular carcinoma after thermal ablation. Methods A retrospective analysis was performed on 329 patients who underwent thermal ablation at our hospital from January 2014 to December 2016 and had complete follow-up data. The overall survival of the patients was analyzed by Kaplan-Meier method. Log-rank test and Cox regression model were used for analyzing the factors that effected overall survival. Results According to the time of tumor progression, the patients were divided into three groups: patients having progression within 1 year, those having progression within 2 years, and those with no progression within 2 years. The 1-, 3-, and 5-year survival rates of the three groups were 88.2%, 40.7%, and 22.0% (progression within 1 year); 98.0% 83.6%, and 50.2% (progression within 2 years); and 99.5%, 97.2%, and 75.2% (no progression within 2 years), respectively, and there were significant differences among them. Cox multivariate analysis showed that the number of tumors, alpha fetoprotein (AFP), alkaline phosphatase (ALP), and albumin-bilirubin (ALBI) grade were independent risk factors affecting the overall survival of patients. The results of subgroup analysis based on the number of tumors, ALBI grade, AFP, and ALP showed that the patients who had tumor progression within 1 year had a poorer overall survival. Conclusion Early progression is associated with long-term prognosis of HCC patients after local thermal ablation. The shorter the time to tumor progression after treatment, the worse the prognosis of HCC patients. Key words: Hepatocellular carcinoma; Thermal ablation; Early recurrence; Prognosis