J Korean Soc Radiol.  2018 Nov;79(5):264-270. 10.3348/jksr.2018.79.5.264.

Tumor Recurrence in Hepatocellular Carcinoma Patients after Radiofrequency Ablation: Portal Hypertension as an Indicator of Recurrence of Hepatocellular Carcinoma

• Jang SW
• Cho YK
• Kim JW
• Gil JR
• Kim MY
• Lee Y

• KMID: 2422903
• DOI: http://doi.org/10.3348/jksr.2018.79.5.264

Abstract

PURPOSE
To evaluate the effect of portal hypertension on the tumor recurrence in patients with hepatocellular carcinoma (HCC) and without hepatic decompression following radiofrequency ablation (RFA).
MATERIALS AND METHODS
Treatment-naïve HCC patients within the Milan criteria and with Child-Pugh class A were included in this study, who had performed RFA in our hospital between January 2010 and March 2017. Univariate and multivariate analyses using the Cox proportional hazard model were performed to find the predictors of local or distant tumor recurrence.
RESULTS
Overall, 178 patients were included in this study. Median follow-up period was 40.2 months. The difference in the local tumor progression rates depending on the absence or presence of portal hypertension was not statistically significant (p = 0.195). The 1-, 3-, and 5-year distant intrahepatic tumor spread rates were 6.6%, 29.5%, and 537% in patients without portal hypertension, and 23.4%, 51.9%, and 63.6% in patients with portal hypertension, respectively. The difference was statistically significant (p = 0.011). Univariate and multivariate analysis showed that portal hypertension was an independent predictor for distant intrahepatic tumor spread (p = 0.008).
CONCLUSION
For HCC patients with Child-Pugh class A, portal hypertension adversely affected distant intrahepatic tumor progression.

MeSH Terms

Carcinoma, Hepatocellular*
Catheter Ablation*
Decompression
Fibrosis
Follow-Up Studies
Humans
Hypertension, Portal*
Liver
Multivariate Analysis
Proportional Hazards Models
Recurrence*

Figure

• 

  Fig. 1 The difference in the recurrence rates depending on the presence of clinically relevant portal hypertension after radiofrequency ablation of hepatocellular carcinoma. A. Local tumor progression rates were similar between the two curves (p = 0.195). B, C. Distant intrahepatic tumor recurrence rates (B), and overall tumor progression rates were statistically higher in patients with clinically relevant portal hypertension (C) (p = 0.011 and p = 0.003, respectively). Note that the curves for distant intrahepatic recurrence and overall tumor progression were nearly identical. HTN = hypertension, RFA = radiofrequency ablation

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