Early diffuse recurrence of hepatocellular carcinoma after percutaneous radiofrequency ablation: Analysis of risk factors

Objective: To evaluate the risk factors affecting early diffuse recurrence within 1year of percutaneous ultrasound-guided radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Methods: Out of 146 patients who received transcatheter arterial chemoembolisation (TACE) for treatment of recurrent HCC after percutaneous ultrasound-guided RFA, we selected 23 patients with early diffuse recurrence. Early diffuse recurrence was defined as three or more new recurrent HCCs within 1year of initial RFA. As a control group, we selected 23 patients, matched exactly for age and sex, in which there was no local tumour progression or new recurrence after RFA. To analyse the risk factors, we examined patient factors and tumour factors. Results: Recurrent tumours occurred from 30 to 365days after RFA (median time, 203days). Univariate analysis indicated that larger tumour size and poorly defined margin were significant risk factors (P < 0.05). Multivariate analysis indicated that poorly defined margin was a significant risk factor (P < 0.05). Conclusion: Larger tumour size and poorly defined margin may be risk factors for early diffuse recurrence of HCC within 1year of RFA. Tumours with such risk factors should be treated with a combination of TACE to minimise the potential for therapeutic failure. Key Points: • Ultrasound-guided radiofrequency ablation (RFA) is widely used for hepatocellular carcinoma (HCC). • Early diffuse recurrence after RFA is an important prognostic factor • The risk factors for recurrence are larger tumour size and poorly defined margins • Tumours with such risk factors should be treated with transarterial chemoembolisation.