Pre-treatment double- or triple-positive tumor markers are predictive of a poor outcome for patients undergoing radiofrequency ablation for hepatocellular carcinoma.

Abstract

We evaluated the therapeutic effect of radiofrequency ablation (RFA) on hepatocellular carcinoma (HCC) according to the number of positive tumor markers. The subjects of this study were 160 patients who underwent percutaneous and surgical RFA for HCC. Patients were divided into negative (n=51), single- (n=69), double- (n=31), and triple-positive (n=9) tumor marker groups according to the pre-treatment expression of these markers. We looked for any relationships among clinical parameters, outcomes, and tumor markers. The 3-year recurrence-free and overall survival rates of the negative, single-, double-, and triple-positive groups were 30, 19, 16, and 11% (P=0.02), and 94, 88, 67, and 37% (P<0.001), respectively. The 2-year local recurrence rates were 6.5, 0, 41.2, and 61.9%, respectively (P<0.001). Multivariate analysis revealed that a double- or triple-positive pre-treatment tumor marker profile was independently associated with local recurrence [hazard ratio (HR) 5.48, 95% confidence interval (CI) 2.44-12.33, P<0.001] and overall survival (HR 4.21, 95% CI 1.89-9.37, P<0.001). RFA may not be suitable for patients with HCC who have pre-treatment expression of ≥two of these tumor markers.