Combined image-guided radiofrequency and iodine-125 seeds implantation in the treatment of recurrent hepatocellular carcinoma after hepatectomy.

BACKGROUND

Currently, there is no consensus on the treatment of recurrent hepatocellular carcinoma (HCC) after hepatectomy. It is necessary to assess the efficacy and safety of radiofrequency ablation (RFA) combined with iodine-125 seeds implantation (RFA-I) in the treatment of recurrent HCC.

METHODS

This study retrospectively analyzed the clinical data of patients with postoperative recurrence of HCC receiving RFA-I or RFA treatment from January 2013 to January 2023. Both RFA and I seeds implantation were performed under dual guidance of ultrasound and CT. Overall survival (OS), progression-free survival (PFS), recurrence, and complications were compared between the two groups.

RESULTS

A total of 210 patients with recurrent HCC were enrolled in this study, including 125 patients in the RFA-I group and 85 patients in the RFA group. The RFA-I group showed a significantly better survival benefit than RFA group (median OS: 37 months vs. 16 months, P < 0.001; median PFS: 15 months vs. 10 months, P = 0.001). The uni- and multivariate analysis showed that RFA-I was a protective factor for OS and PFS. There were no procedure-related deaths and no grade 3 or higher adverse events in both groups.

CONCLUSIONS

RFA combined with I seeds implantation under dual guidance of ultrasound and CT is effective and safe for the treatment of HCC patients with recurrence after hepatectomy.