肝细胞癌经皮射频消融术后复发：复发模式及危险因素分析

Recurrence after percutaneous radiofrequency ablation of hepatocellular carcinoma: Analysis of the pattern and risk factors.

作者信息

Chen Rui, Hou Beining, Zhou Yanzhao, Zhang Tuo, Wang Zhengzheng, Chen Xun, Zhang Yingwei, Chen Man

机构信息

Department of Critical Care Medicine, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China.

Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian, China.

出版信息

Front Oncol. 2023 Feb 23;13:1018715. doi: 10.3389/fonc.2023.1018715. eCollection 2023.

BACKGROUND

Hepatocellular carcinoma (HCC) frequently relapses after minimally invasive treatment. This study aimed to observe the influencing factors of different recurrence patterns after radiofrequency ablation (RFA) for the treatment of recurrence.

METHODS

The medical records of HCC patients who underwent RFA between January 2010 and January 2019 were retrospectively reviewed. HCC recurrence is classified into three types: local tumour progression (LTP), intrahepatic distant metastasis, and extrahepatic metastasis. Risk factors, overall survival (OS), and disease-free survival (DFS) were assessed for each modality. Among the risk factors are age, gender, liver function tests, blood tests, and tumour size. The OS and DFS curves were measured by the Kaplan-Meier method.

RESULTS

406 patients who had undergone RFA were included in the study. The median survival for OS and DFS were 120 and 43.6 months. During follow-up, 39, 312, and 55 patients developed LTP, intrahepatic distant metastasis, and extrahepatic metastatic recurrence, respectively. The independent risk factors for each type were as follows: WBC > 5.55*10/L was an independent risk factor for local recurrence. Multiple tumours, extrahepatic metastases, and AFP > 200 ng/ml were used for intrahepatic metastases. Age ( = 0.030), recurrence pattern ( < 0.001) and Child-Pugh class B ( = 0.015) were independent predictors of OS.

CONCLUSIONS

According to our classification, each pattern of recurrence has different risk factors for recurrence, OS, and DFS.

背景

肝细胞癌（HCC）在微创治疗后常复发。本研究旨在观察射频消融（RFA）治疗复发后不同复发模式的影响因素。

方法

回顾性分析2010年1月至2019年1月期间接受RFA治疗的HCC患者的病历。HCC复发分为三种类型：局部肿瘤进展（LTP）、肝内远处转移和肝外转移。评估每种复发模式的危险因素、总生存期（OS）和无病生存期（DFS）。危险因素包括年龄、性别、肝功能检查、血液检查和肿瘤大小。采用Kaplan-Meier法绘制OS和DFS曲线。

结果

本研究纳入406例行RFA治疗的患者。OS和DFS的中位生存期分别为120个月和43.6个月。随访期间，分别有39例、312例和55例患者出现LTP、肝内远处转移和肝外转移复发。每种复发类型的独立危险因素如下：白细胞计数>5.55×10⁹/L是局部复发的独立危险因素。多发肿瘤、肝外转移和甲胎蛋白>200 ng/ml用于肝内转移的评估。年龄（P = 0.030）、复发模式（P < 0.001）和Child-Pugh B级（P = 0.015）是OS的独立预测因素。