Prognostic analysis for patients with hepatocellular carcinoma complicated with portal hypertension after radiofrequency ablation

Abstract

Objective To investigate the prognosis and its influencing factors for patients with hepatocellular carcinoma (HCC) complicated with portal hypertension (PHT) after radiofrequency ablation (RFA). Methods Clinical data of 223 patients with HCC who were treated with RFA for the first time in the Affiliated Hospital of Qingdao University from January 2011 to December 2015 were retrospectively analyzed. There were 168 males and 55 females, aged from 31 to 80 years old with the median of 57 years old. The patients were divided into PHT group and non PHT group according to whether they were complicated with PHT or not. The informed consents of all patients were obtained and the local ethical committee approval was received. RFA was performed under the guidance of ultrasound or CT, and the patients were followed up after operation. Survival analysis was conducted by Kaplan-Meier and Log-rank tests, and multivariate analysis was conducted by Cox hazard regression model. Results The median follow-up time of the patients was 38(8-79) months. The results of Kaplan-Meier analysis showed that the 1-, 2-, 5-year tumor free survival rates of PHT group were 85.8%, 67.7%, 43.8% respectively, and those of non PHT group were 90.0%, 79.9% and 62.1% correspondingly, and significant difference was observed (χ2=8.357, P 100 μg/L was an independent risk factor for the tumor-free survival of patients with HCC complicated with PHT after RFA treatment (HR=1.824, P<0.05). Preoperative alcoholism was an independent risk factor for the overall survival of patients with HCC complicated with PHT after RFA treatment (HR=2.724, P<0.05). Conclusions The tumor-free survival rate and overall survival rate of patients with PHT after RFA treatment are significantly lower than those without PHT. Preoperative AFP elevation is an independent risk factor for tumor-free survival, and preoperative alcoholism is an independent risk factor for overall survival. Key words: Carcinoma, hepatocellular; Hypertension, portal; Catheter ablation; Prognosis