Risk factors for distant recurrence of hepatocellular carcinoma in the liver after complete coagulation by microwave or radiofrequency ablation

BACKGROUND, In patients with hepatocellular carcinoma (HCC), recurrences in the distant liver often are observed after curative treatment. Microwave c oagulation therapy (MCT) and radiofrequency ablation (RFA) have been develo ped as less invasive alternatives than surgical resection for small HCCs. I n the current study, risk factors for distant recurrence of HCC were analyz ed in patients in whom complete coagulation was achieved. METHODS. Ninety-two patients with HCCs < 3 cm in greatest dimension were tr eated by MCT or RFA percutaneously or laparoscopically. Eighty-four patient s in whom complete coagulation was achieved without recurrence in the same subsegment as the primary nodule were included in this study. Distant recur rences were observed in 22 patients. Fifteen possible risk factors for a di stant recurrence were analyzed. RESULTS. When comparing the patients with a recurrence of HCC nodules in th e remnant liver to those without recurrence, the authors observed a statist ically significant difference only in serum <alpha>-fetoprotein. The distan t recurrence-free survival was analyzed by the Kaplan-Meier method. A stati stically significant difference was observed in hepatitis C virus (HCV) inf ection as an etiopathic agent of underlying liver diseases (P < 0.005) and in the number of the primary HCC nodules (P < 0.05, log-rank test). A multi variate stepwise Cox hazard model revealed that HCV infection and the numbe r of primary HCC nodules were statistically independent risk factors. CONCLUSIONS, Patients who had more than two HCC nodules accompanied by HCV infection had a high incidence of recurrence of HCC in the remnant liver, e ven when coagulation by microwave or ablation by radiofrequency was complet e. (C) 2001 American Cancer Society.