Comparison Of Clinical Efficacy Of Radiofrequency Ablation For Postoperative Recurrent And Primary Hepatocellular Carcinoma

Objective: To compare the prognosis of radiofrequency ablation(RFA)for postoperative recurrent hepatocellular carcinoma and primary hepatocellular carcinoma,and identify the prognostic factors for the RFA to the postoperative recurrent hepatocellular carcinoma.Methods: A total of 506 patients with hepatocellular carcinoma receiving RFA treatment from 2009 to 2015 was screened.Among them,82 patients with postoperative recurrent hepatocellular carcinoma(recurrent group)were enrolled.97 patients with hepatocellular carcinoma(primary group)who received RFA treatment at the same period was included as well.Baseline data of two groups was balanced by propensity score matching.Overall survival rate(OS)and disease-free survival rate(DFS)were analyzed by Kaplan-meier log-rank test before and after propensity score matching.The prognostic factors of RFA for recurrent hepatocellular carcinoma were analyzed by COX proportional hazard regression.Results: The media follow-up time was 36.5 months for recurrent group and 40 months for primary group.The 1-,3-and 5-years OS of the recurrentgroup were 93%,73% and 61%,respectively and 85%,75% and 61% for the primary group.Corresponding DFS of the two groups were respectively 61%,39%,21% and 79%,64%,46%.There was no significant difference in the OS between the two groups(P=0.896),but the DFS in the primary group was statistical significantly longer than that in the recurrent group(P=0.048).After propensity score matching,the 1-,3-and 5-years OS of recurrent and primary was 88%、70%、62% and 90%、85%、67%.Corresponding DFS was 55%、35%、11% and 75%、55%、34%.The OS was not statistically different(P=0.264).However,the primary group was with a longer DFS than the recurrent group(P=0.022).The independent risk factors affecting the OS of the recurrent group were the interval between hepatectomy to recurrence(P=0.033)and the Child-Pugh grading before RFA(P=0.01).Conclusion: The DFS of patients with postoperative recurrent hepatocellular carcinoma were shorter than the primary hepatocellular carcinoma when treated by RFA,however the OS was not significantly different.The interval between hepatectomy to recurrence and the Child-Pugh liver grading before RFA were prognostic factors for the recurrent hepatocellular carcinoma.