Fukuhara Takayuki, Aikata Hiroshi, Hyogo Hideyuki, Honda Yohji, Morio Kei, Morio Reona, Hatooka Masahiro, Kobayashi Tomoki, Naeshiro Noriaki, Kawaoka Tomokazu, Tsuge Masataka, Hiramatsu Akira, Imamura Michio, Kawakami Yoshiiku, Chayama Kazuaki
Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Eur J Radiol. 2015 Aug;84(8):1540-1545. doi: 10.1016/j.ejrad.2015.04.020. Epub 2015 Apr 28.
To determine the efficacy of radiofrequency ablation (RFA) for initial recurrence of small hepatocellular carcinoma (HCC; ≤3 nodules, each nodule ≤3cm in diameter) after curative treatment and identify prognostic factors affecting therapeutic outcome, we compared clinical and outcome factors between patients with primary HCC and those with initial recurrent HCC who underwent RFA.
In this retrospective cohort study, 211 HCC patients who underwent RFA were enrolled and comprised two groups: primary group (n=139) and initial recurrent group (n=72). We compared local tumor progression, overall survival (OS), disease-free survival (DFS), and RFA safety between the groups.
Median follow-up was 53 months. Local tumor progression rate was 5.8% in the primary group and 4.2% in the recurrent group. OS rates at 5 years and 10 years were 63.2% and 25.5% in the primary group and 54.5% and 33.4% in the recurrent group, respectively. Corresponding DFS rates were 30.7% and 14.6% and 19.2% and 11.0%. DFS was significantly shorter in the recurrent group (hazard ratio [HR]=1.81; 95% confidence interval [CI], 1.27-2.57; P=0.001). In the recurrent group, time from primary HCC development to recurrence was a determinant of OS (≤2 years; HR=3.42; 95% CI, 1.52-7.72; P=0.003).
Although local tumor control and OS were similar between the groups, the recurrent group had shorter DFS than the primary group. Time from primary HCC development to recurrence was a prognostic factor for recurrence of HCC.
为了确定射频消融（RFA）治疗小肝细胞癌（HCC；≤3个结节，每个结节直径≤3cm）根治性治疗后首次复发的疗效，并识别影响治疗结果的预后因素，我们比较了接受RFA治疗的原发性HCC患者和首次复发性HCC患者的临床及预后因素。
在这项回顾性队列研究中，纳入了211例行RFA治疗的HCC患者，分为两组：原发性组（n = 139）和首次复发组（n = 72）。我们比较了两组间的局部肿瘤进展、总生存期（OS）、无病生存期（DFS）和RFA安全性。
中位随访时间为53个月。原发性组局部肿瘤进展率为5.8%，复发组为4.2%。原发性组5年和10年的OS率分别为63.2%和25.5%，复发组分别为54.5%和33.4%。相应的DFS率分别为30.7%和14.6%以及19.2%和11.0%。复发组的DFS明显更短（风险比[HR]=1.81；95%置信区间[CI]，1.27 - 2.57；P = 0.001）。在复发组中，从原发性HCC发生到复发的时间是OS的一个决定因素（≤2年；HR =
