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- Title
Noninvasive fibrosis indices predict intrahepatic distant recurrence of hepatitis B-related hepatocellular carcinoma following radiofrequency ablation.
- Authors
Seo, Ji Yeon; Kim, Won; Kwon, Jee Hye; Jin, Eun Hyo; Yu, Su Jong; Kim, Hwi Young; Jung, Yong Jin; Kim, Donghee; Kim, Yoon Jun; Yoon, Jung‐Hwan; Lee, Hyo‐Suk
- Abstract
Backgrounds & aims Intrahepatic recurrence of hepatocellular carcinoma ( HCC) after radiofrequency ablation ( RFA) occurs as a result of direct dissemination or de novo oncogenesis. Hepatocellular carcinogenesis is related to the progression of cirrhosis, and noninvasive fibrosis scoring systems reflect the severity of hepatic fibrosis. Hence, the aim of this study was to elucidate the correlation between noninvasive fibrosis indices and intrahepatic distant recurrence ( IDR) of HCC after RFA. Methods Patients with hepatitis B virus ( HBV)-related, solitary HCC undergoing RFA were prospectively enrolled. Noninvasive serum fibrosis indices were calculated at the time of RFA. IDR was defined as recurrent HCC beyond >2 cm from the ablation margin of RFA. Predictors of IDR and overall survival were analysed by a Cox regression model. Results Two hundred forty-six patients received RFA as initial treatment, and the median follow-up duration was 19.7 months (IQR, 11.9-29.8). Among these cases, 133 (45.9%) showed IDR after RFA. In multivariable analysis, serum alpha-fetoprotein ( AFP) (HR, 1.000; 95% CI, 1.000-1.001; P = 0.001) and age-platelet index ( API) (1.19; 1.01-1.39; P = 0.033) were independent predictors of IDR. In particular, patients with API ≤7 showed a significantly higher recurrence-free survival rate than patients with API >7 ( P = 0.004). With regard to overall survival, male sex (4.69; 1.52-14.52; P = 0.007), serum bilirubin (2.78; 1.31-5.90; P = 0.008) and AFP (1.000; 1.000-1.001; P = 0.006) were significantly correlated with shortened survival. Conclusion High levels of AFP and API predict IDR of HBV-related HCC after RFA. Therefore, noninvasive fibrosis indices could play an important role in predicting IDR of HCC following percutaneous ablation.
- Subjects
CANCER risk factors; LIVER cancer; CATHETER ablation; FIBROSIS; CIRRHOSIS of the liver; HYPERBILIRUBINEMIA; MULTIVARIATE analysis
- Publication
Liver International, 2013, Vol 33, Issue 6, p884
- ISSN
1478-3223
- Publication type
Article
- DOI
10.1111/liv.12132