Carcinoma Undergoing Radiofrequency Ablation Research Articles

Impact of HCV eradication on recurrence pattern and long-term outcomes in patients with HCV-related hepatocellular carcinoma undergoing radiofrequency ablation.

The benefits of HCV eradication on distinct recurrence patterns and long-term hepatic outcomes in patients with hepatocellular carcinoma (HCC) undergoing radiofrequency ablation (RFA) remain uncertain. This study aims to assess the impact of HCV eradication on HCC recurrence patterns and long-term hepatic outcomes after RFA and to identify predictors of recurrence in patients achieving sustained virological response (SVR). We retrospectively enrolled 274 patients receiving RFA for HCV-related HCC, including 73 and 88 patients treated with interferon-based (IFN) and direct-acting antivirals (DAA) therapy, respectively. We analysed factors associated with local tumour progression (LTP), distant recurrence, overall survival, and hepatic decompensation. SVR was achieved in 49.3% of patients undergoing IFN therapy and 93.2% of patients undergoing DAA therapy. HCV eradication was not associated with LTP but significantly correlated with reduced risk of distant recurrence (by DAA: hazard ratio (HR) = 0.449, p = 0.006), overall survival (by IFN: HR = 0.242, p < 0.001; by DAA: HR = 0.274, p < 0.001) and hepatic decompensation (by IFN: HR = 0.313, p = 0.004; by DAA: HR = 0.281, p < 0.001). The benefits of achieving SVR in terms of overall survival and hepatic decompensation remained significant in subgroups of patients with and without recurrence. Patients with SVR showed a significant decline in FIB-4 score and a higher proportion of ALBI grade improvement. Among SVR patients, the IMbrave050 criteria predicted LTP but not distant recurrence, whereas the FIB-4 score after SVR, rather than the baseline FIB-4, predicted distant recurrence. HCV eradication was associated with a significant reduction in distant recurrence, mortality and hepatic decompensation following RFA in patients with HCV-related HCC.

Risk Models for Predicting the Recurrence and Survival in Patients With Hepatocellular Carcinoma Undergoing Radio-Frequency Ablation

Background: Hepatocellular carcinoma (HCC) patients have a poor prognosis after radio-frequency ablation (RFA), and investigating the risk factors affecting RFA and establishing predictive models are important for improving the prognosis of HCC patients. Methods: Patients with HCC undergoing RFA in Shenzhen People’s Hospital between January 2011 and December 2021 were included in this study. Using the screened independent influences on recurrence and survival, predictive models were constructed and validated, and the predictive models were then used to classify patients into different risk categories and assess the prognosis of different categories. Results: Cox regression model indicated that cirrhosis (hazard ratio [HR] = 1.65), alpha-fetoprotein (AFP) ⩾400 ng/mL (HR = 2.03), tumor number (multiple) (HR = 2.11), tumor diameter ⩾20 mm (HR = 2.30), and platelets (PLT) ⩾ 244 (109/L) (HR = 2.37) were independent influences for recurrence of patients after RFA. On the contrary, AFP ⩾400 ng/mL (HR = 2.48), tumor number (multiple) (HR = 2.52), tumor diameter ⩾20 mm (HR = 2.25), PLT ⩾244 (109/L) (HR = 2.36), and hemoglobin (HGB) ⩾120 (g/L) (HR = 0.34) were regarded as independent influences for survival. The concordance index (C-index) of the nomograms for predicting disease-free survival (DFS) and overall survival (OS) was 0.727 (95% confidence interval [CI] = 0.770-0.684) and 0.770 (95% CI = 0.821-7.190), respectively. The prognostic performance of the nomograms was significantly better than other staging systems by analysis of the time-dependent C-index and decision curves. Each patient was scored using nomograms and influencing factors, and patients were categorized into low-, intermediate-, and high-risk groups based on their scores. In the Kaplan-Meier survival curve, DFS and OS were significantly better in the low-risk group than in the intermediate- and high-risk groups. Conclusions: The 2 prediction models created in this work can effectively predict the recurrence and survival rates of HCC patients following RFA.

Tumor burden score as a new prognostic surrogate in patients with hepatocellular carcinoma undergoing radiofrequency ablation: role of albumin-bilirubin (ALBI) grade vs easy ALBI grade

ABSTRACT Introduction Tumor burden score (TBS) was proposed to represent tumor burden in solid tumors, including hepatocellular carcinoma (HCC). The prognostic role of TBS in HCC patients in relation to recently introduced liver reserve markers, albumin-bilirubin (ALBI) grade, and easy (EZ)-ALBI grade, is unclear. We aimed to investigate the feasibility of TBS in HCC patients undergoing radiofrequency ablation (RFA). Research design and methods A total of 576 treatment-naïve patients with HCC undergoing RFA were analyzed. The multivariate Cox analysis was used to identify independent predictors associated with tumor recurrence and long-term survival. Results Patients with high TBS had increased risk of tumor recurrence and mortality compared with those with low TBS. The Cox analysis showed that serum ɑ-fetoprotein (AFP) level >20 ng/mL, medium and high TBS, ALBI grade 2 and grade 3, EZ-ALBI grade 2 and grade 3 were associated with tumor recurrence and decreased patient survival (all p <0.05). In addition, TBS can reliably stratify tumor recurrence and overall survival in different ALBI and EZ-ALBI grade groups. Conclusions TBS is a simple and feasible prognostic surrogate to predict tumor recurrence and survival in HCC patients undergoing RFA. Its prognostic ability remains stable in patients with variable liver functional reserve.

Preoperative prognostic value of alfa-fetoprotein density in patients with hepatocellular carcinoma undergoing radiofrequency ablation

Objectives To examine the prognostic value of preoperative alfa-fetoprotein (AFP) density and other clinical factors in patients undergoing percutaneous radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC). Methods From January 2010 to December 2018, a total of 543 patients undergoing RFA for HCC meeting the Milan criteria were included at our institution. AFP density was calculated as absolute AFP pre-ablation divided by the total volume of all HCC lesions. The survival rates according to AFP density were estimated using the Kaplan–Meier method and compared using the log-rank test. Univariate and multivariate Cox proportional-hazards regression analyses were used to assess predictors of overall survival (OS) and progression-free survival (PFS). Results The Kaplan–Meier 1-, 3-, and 5-year OS rates were 98.8%, 88.5%, and 70.4%, respectively, for the low AFP density group, and 98.3%, 74.9%, and 49.4%, respectively, for the high AFP density group. The corresponding PFS rates were 78.9%, 56.7%, and 40.9% (low AFP density group), and 63.6%, 40.8%, and 27.5% (high AFP density group). High AFP density was associated with significantly reduced PFS and OS (both p < 0.001). Multivariate analysis suggested that AFP density was a predictor of OS and PFS. Conclusions Serum AFP density may serve as a promising predictor of survival in patients with HCC undergoing RFA. High AFP density could identify patients who might be prone to recurrence or progression and need close surveillance.

Effect of Nursing Strategies on the Performance and Satisfaction of Patients with Hepatocellular Carcinoma undergoing Radiofrequency Ablation Therapy

Effect of Nursing Strategies on the Performance and Satisfaction of Patients with Hepatocellular Carcinoma undergoing Radiofrequency Ablation Therapy

Quality of life for patients with Hepatocellular carcinoma undergoing Radio frequency Ablation

Quality of life for patients with Hepatocellular carcinoma undergoing Radio frequency Ablation

A Single Center Retrospective Analysis of Patients with Recurrent Papillary Thyroid Carcinoma Undergoing Radiofrequency Ablation

Background: Radiofrequency ablation (RFA) is used in selected patients with recurrent or metastatic thyroid cancer who have high surgical risk or do not accept surgical treatment. However, long-term follow-up data are limited. Here, we present our single-center experience with the use of RFA in the treatment of recurrent or metastatic papillary thyroid carcinoma (PTC).&#x0D; Material and Methods: Patients who underwent RFA for recurrent or metastatic PTC at Bursa Uludag University Faculty of Medicine between September 2014 and January 2021 were included. The data in the endocrinology outpatient clinic follow-ups of the patients were analyzed retrospectively.&#x0D; Results: A total of 10 patients, 11 RFA procedures, and 13 residual or metastatic sites were evaluated. The mean age was 44.50±14.04 years. The mean largest diameter of the tumor in which RFA was applied was 11.85±5.95 mm. Patients developed no major complications. Two patients experienced minor complications. The mean follow-up duration was of 51.20±19.86 months. During the follow-up period, 12 (92.30%) of 13 RFA sites completely disappeared. In one patient (7.69%) residual tumor tissue was detected after RFA. There was no recurrence at the procedure site. A significant decrease was found in the largest diameter of the treated regions after RFA (p=0.002). Thyroglobulin and anti-thyroglobulin levels were not significantly different before and after RFA (p=0.44 and p=1.00, respectively). &#x0D; Conclusions: RFA is highly effective and safe for locally recurrent PTC. It shows promise as an alternative to surgery to control locoregional recurrence of PTC.

The Prognostic Value of the Albumin to Gamma-Glutamyltransferase Ratio in Patients with Hepatocellular Carcinoma Undergoing Radiofrequency Ablation.

Albumin to gamma-glutamyltransferase ratio (AGR) is a newly developed biomarker for the prediction of patients' prognosis in solid tumors. The purpose of the study was to establish a novel AGR-based nomogram to predict tumor prognosis in patients with early-stage HCC undergoing radiofrequency ablation (RFA). 394 hepatocellular carcinoma (HCC) patients who had received RFA as initial treatment were classified into the training cohort and validation cohort. Independent prognostic factors were identified by univariate and multivariate analyses. The value of AGR was evaluated by the concordance index (C-index), receiver operating characteristic (ROC) curves, and likelihood ratio tests (LAT). Logistic regression and nomogram were performed to establish the pretreatment scoring model based on the clinical variables. As a result, AGR = 0.63 was identified as the best cutoff value to predict overall survival (OS) in the training cohort. According to the results of multivariate analysis, AGR was an independent indicator for OS and recurrence-free survival (RFS). In both training cohort and validation cohort, the high-AGR group showed better RFS and OS than the low-AGR group. What is more, the C-index, area under the ROC curves, and LAT χ2 values suggested that AGR outperformed the Child-Pugh (CP) grade and albumin-bilirubin (ALBI) grade in terms of predicting OS. The AGR, AKP, and tumor size were used to establish the OS nomogram. Besides, the results of Hosmer-Lemeshow test and calibration curve analysis displayed that both nomograms in the training and validation cohorts performed well in terms of calibration. Therefore, the AGR-based nomogram can predict the postoperative prognosis of early HCC patients undergoing RFA.

Effect of Self-Care Guidelines on Quality of Life for Patients with Hepatocellular Carcinoma Undergoing Radiofrequency Ablation

Context: Hepatocellular carcinoma (HCC) is considered one of the most challenging tumors with high incidence, prevalence, and mortality rates. Radiofrequency Ablation (RFA) is one of the emerging therapeutic modalities used for the minimally invasive treatment in the management of early-stage HCC.&#x0D; Aim: This study aimed to assess the effect of self-care guidelines on quality of life for patients with Hepatocellular Carcinoma undergoing Radio Frequency Ablation.&#x0D; Methods: A quasi-experimental design was used to achieve the aim of this study. This study was conducted at the Interventional Radiology Unit, affiliated to Ain Shams University Hospital, on a purposive sample of 50 patients with hepatocellular carcinoma; 25 randomly allocated to the study group, and 25 allocated to the control group. A structured interview questionnaire for patients with hepatocellular carcinoma undergoing radiofrequency ablation was used to collect the study data. It comprises three parts: Sociodemographic characteristic, assessment of patients' medical health, and knowledge about HCC and RFA. The second tool was the quality of life of cancer survivors questionnaire (pre /posttest), and finally, a patient-reported self-care practices assessment checklist (pre /posttests).&#x0D; Results: There were statistically significant differences between the study and control groups regarding their total knowledge about hepatocellular carcinoma and radiofrequency ablation therapy pre and post-implementation of self-care guidelines. There were highly statistically significant differences between both groups regarding the total quality of life, pre and post-implementation of self-care guidelines. In addition, there were highly statistically significant differences regarding total self-care practice, pre, and post-implementation of self-care guidelines. A positive correlation was revealed between total knowledge with total self-care practice and total quality of life (pre/posttest). Also, a significant correlation was revealed between the total quality of life and self-care practices post self-care guidelines implementation at (p&lt;0.001).&#x0D; Conclusion: Implementation of self-care guidelines were improved patients' knowledge, quality of life, and self-care practices for patients with hepatocellular carcinoma undergoing radiofrequency ablation. A simplified, illustrated, and comprehensive Arabic booklet including self-care guidelines should be available for patients with hepatocellular carcinoma undergoing radiofrequency ablation. Replication of the current study on a larger probability sample is recommended to achieve generalization of the results. Further studies are recommended to assess factors affecting the quality of life for patients with hepatocellular carcinoma undergoing radiofrequency ablation.

Albumin-to-alkaline phosphatase ratio as a predictor of tumor recurrence and prognosis in patients with early-stage hepatocellular carcinoma undergoing radiofrequency ablation as initial therapy

Objective Albumin-to-alkaline phosphatase ratio (AAPR), a newly developed blood biomarker, has been reported to have prognostic value in several types of cancer. This study aimed to investigate the predictive value of AAPR in patients with early-stage hepatocellular carcinoma (HCC) undergoing radiofrequency ablation (RFA) as initial therapy. Methods This retrospective study analyzed 445 patients with newly diagnosed HCC undergoing RFA as initial therapy. A series of survival analyses were performed to evaluate the prognostic value of AAPR. Univariate and multivariate analyses were performed to identify independent prognostic factors. An AAPR-based nomogram was constructed, and its predictive performance was validated. Results Patients with a low AAPR had a significantly reduced recurrence-free survival (RFS) and overall survival (OS) compared with those with a high AAPR. AAPR was found to be an independent prognostic indicator and showed superior discrimination efficacy than other liver function indices. The AAPR-based nomogram had a concordance index value of 0.72 (95% confidence interval [CI]: 0.65–0.79) in the training cohort and 0.72 (95% CI: 0.63–0.81) in the validation cohort, which significantly outperformed other existing staging systems. Conclusions AAPR serves as a promising indicator of prognosis in patients with early-stage HCC undergoing RFA. The AAPR-based nomogram might contribute to individualized prognosis prediction and clinical decision making.

Effect of Nursing Care Instructions on Outcomes of Patients with Hepatocellular Carcinoma Undergoing Radiofrequency Ablation Therapy

Effect of Nursing Care Instructions on Outcomes of Patients with Hepatocellular Carcinoma Undergoing Radiofrequency Ablation Therapy

Development and validation of a prognostic model for patients with hepatocellular carcinoma undergoing radiofrequency ablation.

BackgroundThere are large variations in prognosis among hepatocellular carcinoma (HCC) patients undergoing radiofrequency ablation (RFA). However, current staging or scoring systems hardly discriminate the outcome of HCC patients treated with RFA.MethodsA total of 757 treatment‐naïve HCC patients undergoing RFA (derivation cohort) were analyzed to establish a nomogram for disease‐free survival (DFS) based on Cox proportional hazard regression model. Accuracy of the nomogram was assessed and compared with conventional staging or scoring systems. Furthermore, external validation was performed in an independent cohort including 208 patients (validation cohort).ResultsTumor size, tumor number, alpha‐fetoprotein, prothrombin induced by vitamin K absence‐II, lymphocyte count, albumin, and presence of ascites were adopted to construct the prognostic nomogram from the derivation cohort. Calibration curves to predict probability of DFS at 3 and 5 years after RFA showed good agreements between the nomogram and actual observations. The concordance index of the present nomogram was 0.759 (95% confidence interval 0.728‐0.790), which was superior to those of conventional staging or scoring systems (range 0.505‐0.683, all P < .001). These results were also reproduced in the validation cohort.ConclusionOur simple‐to‐use nomogram optimized for treatment‐naïve HCC patients undergoing RFA provided better prognostic performance than conventional staging or scoring systems.

Prognostic value of enhancement rate by enhanced ultrasound in hepatitis B virus-positive hepatocellular carcinoma undergoing radiofrequency ablation.

To assess the prognostic significance of enhancement rate (ER) measured by contrast-enhanced ultrasonography (CEUS) in patients with hepatocellular carcinoma (HCC) undergoing radiofrequency ablation (RFA). A total of 253 patients with single primary HCC undergoing preoperative CEUS and RFA were enrolled in this study. The ER were evaluated though pretreatment CEUS. After a mean follow-up of 36.8 ± 10.2 months, the correlation of ER measured by CEUS and survival after RFA was analyzed by univariate and multivariate analysis. The optimal cutoff ER value to predict survival was determined using receiver-operating characteristic analysis. Mean follow-up period for all 253 patients was 36.8 ± 10.2 months, 31.2% of patients had died at endpoint. The optimal cutoff ER value predicting survival was 2.2dB/s. Univariate analysis demonstrated that patients with a high ER level had poorer OS (62.8months vs 48.8 months, P=0.02) and recurrence-free survival (RFS = 60.2months vs 47.4 months, P=0.03) than patients with a low ER level. ER measured by CEUS also been confirmed as independent risk factor for overall survival (hazard ratio [HR], 1.87; 95% confidence interval [95% CI], 1.21-7.25; P<0.01) and RFS (HR, 1.67; 95% CI, 1.08-6.21; P<0.01) in multivariate analysis enrolling gender, BMI, tumor size, antiviral therapy, HBV DNA, histological differentiation, Child-Pugh score and tumor node metastasis (TNM) stage. ER measured by CEUS was a significant predictive factor for survival after RFA for HCC.

Serum levels of ferritin do not affect the prognosis of patients with hepatocellular carcinoma undergoing radiofrequency ablation.

Background & aimsHepatic iron accumulation can accelerate liver injury in patients with various chronic liver diseases and lead to hepatocarcinogenesis. We elucidated the impact of serum levels of ferritin on the prognosis of hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA) in a large cohort.MethodsWe retrospectively analyzed 578 treatment-naïve HCC patients who underwent RFA. We divided our cohort into four groups by the quartile points of serum ferritin level: G1 (≤55 ng/mL, n = 148), G2 (56–130 ng/mL, n = 142), G3 (131–243 ng/mL, n = 144) and G4 (≥244 ng/mL, n = 144). We analyzed the recurrence and survival of patients using the Kaplan–Meier method. We also evaluated pathological iron deposition among patients with a solitary tumor smaller than 2 cm.ResultsThe cumulative rates of overall recurrence and survival at 5 years were 81.6% and 66.3%, respectively. The serum levels of ferritin were correlated with pathological iron deposition. There were no significant differences in recurrence and survival rates according to serum levels of ferritin and pathological hepatic iron deposition.ConclusionsSerum levels of ferritin do not affect the prognosis of HCC patients undergoing RFA.

Prognostic Performance of Ten Liver Function Models in Patients with Hepatocellular Carcinoma Undergoing Radiofrequency Ablation

Liver functional capacity is a crucial survival determinant for hepatocellular carcinoma (HCC). Noninvasive models were proposed to assess hepatic reserve, but their performance in outcome prediction is unclear. We aimed to investigate 10 currently used liver function models in HCC patients undergoing radiofrequency ablation (RFA). A total 499 HCC patients were prospectively identified. Homogeneity and corrected Akaike information criteria (AICc) were compared. Cox proportional hazards model was used to identify independent survival predictors. Significance survival differences were found across 10 noninvasive models (all p < 0.001) except for GUCI and APRI grade 2 vs 3, and King’s score grade 1 vs 2. Among these models, ALBI grade showed the highest homogeneity and lowest AICs value, indicating a better prognostic performance. Within Child-Turcotte-Pugh (CTP) score 5 group, significant survival difference was demonstrated between ALBI grade 1 and 2 (p < 0.001); for those with CTP score 6 or higher, only ALBI grade 2 and 3 showed survival difference (p < 0.001). Cox analysis disclosed that ALBI grade, tumor size and performance status were independent prognostic predictors. There was significant correlation between CTP score and other 9 models. We conclude that ALBI grade may serve as objective and feasible surrogate for prognostic prediction in HCC patients undergoing RFA.

Implication of Psoas Muscle Index on Survival for Hepatocellular Carcinoma Undergoing Radiofrequency Ablation Therapy.

Aims We aimed to retrospectively examine the impact of pretreatment psoas muscle index (PMI) as determined by computed tomography on survival for treatment naïve hepatocellular carcinoma (HCC) patients who underwent percutaneous radiofrequency ablation (RFA) therapy (n=182; 111 males and 71 females with median age of 70 years).Patients and methods Optimal cut-off points of PMI in male and female were calculated by receiver operating characteristic analysis for survival. We investigated parameters associated with overall survival (OS) in the univariate and multivariate analyses.Results The median follow-up period in this study was 4.28 years. For all cases, the 5-year cumulative OS rate after initial RFA was 69.2%. The median (range) value in PMI for male was 6.03 (1.63-9.90) cm2/m2 whereas that for female was 4.06 (1.21-7.32) cm2/m2. Maximum tumor size ranged from 0.7 cm to 3.5 cm (median, 1.5cm). There were 145 patients with single nodule and 37 with multiple nodules. The optimal cut-off point for PMI was 6.31 cm2/m2 in male and 3.91 cm2/m2 in female. The 5-year cumulative OS rates were 51.5% in the decreased PMI group (n=90) and 86.5% in the non-decreased PMI group (n=92) (P<0.0001). In patients with Child-Pugh A (n=137) and Child-Pugh B or C (n=45), similar results were obtained. In the multivariate analysis, presence of decreased PMI (P<0.0001), total bilirubin ≥1.2 mg/dl (P=0.0015) and des-γ-carboxy prothrombin ≥34 mAU/ml (P=0.0089) were found to be significant adverse predictors related to OS.Conclusion PMI can be useful for predicting outcomes in HCC patients undergoing percutaneous RFA therapy.

Impact of renal insufficiency on patients with hepatocellular carcinoma undergoing radiofrequency ablation.

Renal insufficiency (RI) is commonly seen in patients with hepatocellular carcinoma (HCC). We aimed to investigate the impact of RI on the long-term survival of HCC patients undergoing radiofrequency ablation (RFA) and to determine the optimal staging strategy for these patients. RI was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m(2) . A total of 123 and 344 patients with and without RI undergoing RFA, respectively, were enrolled. A one-to-one propensity score matching analysis with preset caliper width was performed. The prognostic ability of four currently used staging systems was compared by the Akaike information criterion (AIC). HCC patients with RI undergoing RFA were older (P < 0.001) and had significantly different baseline characteristics. Of all patients, RI was significantly associated with a decreased long-term survival (P = 0.03). After matching in the propensity model, the baseline characteristics were similar between patients with (n = 92) and without (n = 92) RI. In the propensity model, RI was not significantly associated with a shortened survival (P = 0.273). In the Cox multivariate analysis, Child-Turcotte-Pugh class B or C was identified as the only independent predictor of poor prognosis. Among patients with RI undergoing RFA, the Taipei Integrated Scoring (TIS) system provided the highest homogeneity and lowest AIC value among the currently used staging systems. The long-term survival of HCC patients undergoing RFA is not affected by RI. The TIS staging system may provide a better prognostic prediction for HCC patients with RI undergoing RFA.

Postoperative Neutrophil-to-Lymphocyte Ratio Change Predicts Survival of Patients with Small Hepatocellular Carcinoma Undergoing Radiofrequency Ablation

BackgroundAn elevated preoperative neutrophil-to-lymphocyte ratio (NLR) has been reported to be a prognostic factor for hepatocellular carcinoma (HCC) patients after treatment. However, the clinical implication of postoperative NLR change remains unclear.Materials and MethodsFrom May 2005 to Aug 2008, a cohort of consecutive 178 small HCC patients treated with radiofrequency ablation (RFA) was retrospectively reviewed. The NLR was recorded within 3 days before and 1 month after RFA. Baseline characteristics, overall survival (OS) and recurrence free survival (RFS) were compared according to preoperative NLR and/or postoperative NLR change. Prognostic factors were assessed by multivariate analysis.ResultsCompared with preoperative NLR level, postoperative NLR decreased in 87 patients and increased in 91 patients after RFA. No significant differences were identified between two groups in commonly used clinic-pathologic features. The 1, 3, 5 years OS was 98.8%, 78.6%, 67.1% for NLR decreased group, and 92.2%, 55.5%, 35.4% for NLR increased group respectively (P<0.001); the corresponding RFS was 94.2%, 65.2%, 33.8% and 81.7%, 46.1%, 12.4% respectively (P<0.001). In subgroup analysis, the survival of patients with lower or higher preoperative NLR can be distinguished more accurate by postoperative NLR change. Multivariate analysis showed that postoperative NLR change, but not preoperative NLR, was an independent prognostic factor for both OS (P<0.001, HR = 2.39, 95%CI 1.53–3.72) and RFS (P = 0.003, HR = 1.69, 95%CI 1.87–8.24).ConclusionThe postoperative NLR change was an independent prognostic factor for small HCC patient undergoing RFA, and patients with decreased NLR indicated better survival than those with increased NLR.