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Risk of tumour progression in early-stage hepatocellular carcinoma after radiofrequency ablation
British Journal of Surgery, 06/25/09

Fernandes ML et al. - In a study to quantify the risk of tumour progression beyond the Milan criteria following radiofrequency (RF) ablation for hepatocellular carcinoma (HCC) and to identify factors associated with tumour progression, this study provides clinicians with an objective risk of tumour progression beyond the Milan criteria after RF ablation at multiple time points. Primary technique failure is identified as a risk factor for tumour progression.

• 111 pts (136 tumours) with liver cirrhosis undergoing RF ablation for HCC within Milan criteria were enrolled.
• Data were analysed retrospectively from a prospectively collected database.

• Cumulative probability of tumour progression beyond the Milan criteria at 6, 12, 18, 24 and 36 mos of RF ablation was 6.4, 11.0, 16.1, 21.2, and 44.8% respectively.
• On multivariable analysis, factors independently associated with tumour progression were failure to achieve primary technique effectiveness, α-fetoprotein level >200 ng/ml, and Child-Pugh grade B cirrhosis.
• Failure to achieve primary RF ablation technique effectiveness was associated with tumour location in segment VIII, a cool-down temperature of 70 °C or less, and multiple overlapping ablations.

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