We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Factors associated with increased risk of peritoneal seeding after radiofrequency ablation for hepatocellular carcinoma.
- Authors
Ryu, Hwaseong; Kim, Tae Un; Lee, Jun Woo; Jeon, Ung Bae; Kim, Jin Hyeok; Jang, Joo Yeon; Yoon, Ki Tae; Hong, Young Mi
- Abstract
Purpose: To evaluate the incidence, risk factors, and prognosis associated with peritoneal seeding after percutaneous radiofrequency ablation (RFA) for HCC, focusing on viable tumors after previous locoregional treatment, including TACE and RFA. Methods: Exactly 290 patients (mean age, 67.9 years ± 9.74; 223 men) with 383 HCCs (mean size, 15.9 mm ± 5.49) who underwent RFA between June 2012 and December 2019 were included in this retrospective study. Among them, 158 had history of previous treatment (mean number, 1.3 ± 1.8) with 109 viable HCCs. Cumulative seeding after RFA was estimated using the Kaplan–Meier method. Independent factors affecting seeding were investigated using multivariable Cox proportional hazards regression analysis. Results: Median follow-up was 1175 days (range: 28–4116). Seeding incidence was 4.1 (12/290) and 4.7% (17/383) per patient and tumor, respectively. The median time interval between RFA and detection of seeding was 785 days (range: 81–1961). Independent risk factors for seeding included subcapsular tumor location (hazard ratio [HR] 4.2; 95% confidence interval [CI] 1.4, 13.0; p = 0.012) and RFA for viable HCC after previous locoregional treatment (HR 4.5; 95% CI 1.7, 12.3; p = 0.003). Subgroup analysis for viable tumors, revealed no significant difference in cumulative seeding rates between the TACE and RFA groups (p = 0.078). Cumulative overall survival rates differed significantly between patients with and without seeding metastases (p < 0.001). Conclusion: Peritoneal seeding after RFA is a rare, delayed complication. Subcapsular-located and viable HCC after previous locoregional treatment are potential risk factors for seeding. Seeding metastases could affect the prognosis of patients who cannot receive local therapy.
- Subjects
CATHETER ablation; PROPORTIONAL hazards models; SOWING; HEPATOCELLULAR carcinoma; SURVIVAL rate; REGRESSION analysis
- Publication
Abdominal Radiology, 2023, Vol 48, Issue 10, p3243
- ISSN
2366-004X
- Publication type
Article
- DOI
10.1007/s00261-023-03987-x