Prognosis and risk factors for recurrence of small liver cancer after a single session of percutaneous radiofrequency ablation

BACKGROUND OBJECTIVE:As a new technique of local therapy for li ve r cancer, radiofrequency ablation (RFA) was widely used these years in China. Th is study was to evaluate the treatment efficacy of RFA on primary liver cancer ( PLC), identify the risk factors of recurrence, and determine the indications of RFA for PLC. METHODS: Records of 94 primary small liver cancer patients underwen t a single session of percutaneous RFA in Liver Cancer Institute/Zhongshan Hospi tal from Jan. 2001 to Dec. 2003 were reviewed retrospectively. Data analyses wer e performed using SPSS for windows Ver. 11.5 software. RESULTS:With a median fo llow-up of 16 months affer RFA treatment, the cumulative survival rate of 94 pa tients was 85.5%at 1 year, and 75.6%at 2 years. The cumulative recurrence-fre e survival rate was 31.3%at 1 year, and 10.4%at 2 years. The total recurrence rate was 66.0%(62/94). Log-rank test revealed that tumor with diameter of 3 c m (P 0.05), proximity to intrahepatic vessels (P 0.01), and subcapsular locat ion (P 0.05) were related to tumor recurrence,while gender, Child-pugh class, alpha fetoprotein (AFP) concentration, and combination therapy with percutaneous ethanol injection were not related to tumor recurrence. Cox regression analysis indicated that tumor proximity to intrahepatic vessels (95%CI, 2.102-7.899; P =0.000), and subcapsular location (95%CI, 1.672-6.289; P=0.001)were associated independently with recurrence after RFA treatment. Severe complications occurre d in 2 cases (2.1%), including 1 case of bile duct hemorrhage, 1 case of sub-d iaphragm effusion. No RFA related death and other severe complications occurred. CONCLUSIONS:RFA appears to be a safe treatment for liver cancer. Patients with tumor diameter of ≤3 cm, no proximity to intrahepatic vessels, and subcapsular location may be the most suitable candidates for RFA.