Risk factors of early recurrence of advanced hepatocellular carcinoma after TACE combined with RFA therapy

Abstract

Objective: To investigate the risk factors of early recurrence after of advanced hepatocellular carcinoma (HCC) TACE combined with RFA therapy. Methods: From June 2008 to December 2015, 90 patients with advanced HCC undergoing TACE combined with RFA therapy in Lishui Central Hospital were collected. The patients were divided into early recurrence group (35 cases) and late recurrence group (55 cases) . The clinical data including age, sex, tumor size, multiple lesions, cirrhosis, metastasis, vascular invasion, sequential treatment, HBV, Child-Pugh classification, BCLC stage, AFP, and surgical history in two groups were compared by t-test and chi-square test. Cox regression analysis was used to predict the risk factors of early recurrence. Kaplan-Meier was used for survival analysis. Results: The tumor size in early recurrence group was greater than that in late recurrence group[ (7.1±1.8) cm vs. (6.0±1.9) cm) ]. The proportion of multiple lesions (77.1% vs. 49.1%) , cirrhosis (71.4% vs. 49.1%) , metastasis (51.4% vs. 27.3%) , vascular invasion (45.7% vs. 16.4%) and sequential treatment (28.6% vs. 61.8%) in early recurrence group were higher than those in late recurrence group. Cox regression analysis showed that multiple lesions, metastasis and vascular invasion were independent risk factors of early recurrence. In addition, the sequential therapy prolonged PFS and OS of patients with HCC. Conclusions: Multiple lesions metastasis and vascular invasion are independent risk factors of early recurrence of advanced HCC after TACE combined with RFA therapy. TACE sequential RFA therapy could prolong PFS and OS of patients, and improve the therapeutic effect. Key words: Hepatocellular carcinoma; Early recurrence; Transcatheter arterial chemoembolization; Radiofrequency ablation; Risk factors; Sequential therapy