Lee Chang Hun, You Ga Ram, Jo Hoon Gil, Jun Chung Hwan, Cho Eun Young, Kim In Hee, Choi Sung Kyu, Yoon Jae Hyun
Department of Internal Medicine, Jeonbuk National University Medical School and Research Institute of Clinical Medicine of Jeonbuk National University Hospital-Jeonbuk National University Medical School, Jeonju 54907, Republic of Korea.
Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun 58128, Republic of Korea.
Cancers (Basel). 2024 Dec 13;16(24):4167. doi: 10.3390/cancers16244167.
Radiofrequency ablation (RFA) is an important local treatment for hepatocellular carcinoma (HCC). This study aimed to evaluate the characteristics of tumor recurrence after RFA and analyze predictors of tumor recurrence and survival in patients with HCC. We retrospectively reviewed data from treatment-naïve patients with HCC who underwent RFA for HCC treatment between 2008 and 2017 at four tertiary hospitals in South Korea. A total of 636 patients with HCC treated with RFA were enrolled in the study. The mean age was 66.3 ± 10.4 years, with 75.0% of patients being male. Most patients (96.7%) had underlying liver cirrhosis, and viral hepatitis (types B and C) accounted for most cases. The average maximum tumor size was 2.2 ± 0.9 cm, with 84.3% of tumors being single lesions. During the follow-up period, 331 patients experienced recurrence, with 95.5% of cases being intrahepatic and one-fifth occurring at the RFA site. Most patients underwent RFA or transarterial chemoembolization as subsequent therapy for recurrence. Multivariate analysis revealed that age, the albumin-bilirubin (ALBI) grade, and Child-Pugh class B status were independent factors associated with tumor recurrence. Only the ALBI grade was significantly associated with mortality. Additionally, the ALBI grade differentiated between recurrence-free survival and overall survival in the Kaplan-Meier survival curve. The ALBI grade was independently associated with tumor recurrence and prognosis in patients with HCC following RFA. This grading system can help clinicians identify high-risk patients, optimize treatment strategies, and enhance patient care.
射频消融（RFA）是肝细胞癌（HCC）的一种重要局部治疗方法。本研究旨在评估RFA术后肿瘤复发的特征，并分析HCC患者肿瘤复发和生存的预测因素。我们回顾性分析了2008年至2017年期间在韩国四家三级医院接受RFA治疗的初治HCC患者的数据。共有636例接受RFA治疗的HCC患者纳入本研究。平均年龄为66.3±10.4岁，75.0%的患者为男性。大多数患者（96.7%）有潜在肝硬化，病毒性肝炎（B型和C型）占大多数病例。平均最大肿瘤大小为2.2±0.9 cm，84.3%的肿瘤为单发。随访期间，331例患者出现复发，95.5%的病例为肝内复发，五分之一发生在RFA部位。大多数患者接受RFA或经动脉化疗栓塞作为复发后的后续治疗。多因素分析显示，年龄、白蛋白-胆红素（ALBI）分级和Child-Pugh B级状态是与肿瘤复发相关的独立因素。只有ALBI分级与死亡率显著相关。此外，在Kaplan-Meier生存曲线中，ALBI分级区分了无复发生存期和总生存期。ALBI分级与RFA术后HCC患者的肿瘤复发和预后独立相关。该分级系统可帮助临床医生识别高危患者，优化治疗策略，并加强患者护理。
