ABSTRACT Aims To analyze risk factors of true early recurrence in patients undergoing radiofrequency ablation (RFA) for early‐stage hepatocellular carcinoma (HCC). Methods and Results We enrolled 791 patients with newly diagnosed early‐stage HCC (i.e., within Milan criteria) and Child–Pugh class A liver disease undergoing percutaneous RFA. Survival analysis was performed using the Kaplan–Meier method with the log‐rank test. Cox proportional hazards analysis was used to identify prognostic factors associated with early recurrence (i.e., recurrence within 2 years after RFA). Early recurrence was identified in 270 (34.1%) patients. After excluding 33 patients with local tumor progression (LTP) within 2 years of initial RFA, 237 patients were classified as showing true early recurrence. Multivariate analyses showed that multiple tumors (hazard ratio HR = 1.526; 95% confidence interval CI = 1.143–2.039), alpha‐fetoprotein (AFP) level of ≥ 10 ng/mL (HR = 1.533; 95% CI = 1.163–2.021), tumor size per 10 mm increase (HR = 1.019; 95% CI = 1.002–1.036), model for end‐stage liver disease (MELD) score per one increase (HR = 1.024; 95% CI = 0.999–1.049), anti‐hepatitis C virus (anti‐HCV) positivity (HR = 1.635; 95% CI = 1.187–2.252), and being treated with antiviral therapy for HCV (HR = 0.614; 95% CI = 0.434–0.869) were associated with inferior 2‐year recurrence‐free survival (RFS). We constructed a predictive model with these variables. This model provided three risk strata for 2‐year RFS, low risk, medium risk, and high risk, with 2‐year RFS of 75%, 58%, and 35%, respectively ( p < 0.001). Conclusions We developed a risk prediction model to predict true early recurrence in patients undergoing RFA for early‐stage HCC.
Yen et al. (Wed,) studied this question.
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