Short- and Long-Term Outcomes of Radiofrequency Ablation for Early Hepatocellular Carcinoma with Liver Dysfunction

Objective: This study aimed to report the short- and long-term outcomes of radiofrequency ablation (RFA) for the treatment of patients with early hepatocellular carcinoma (HCC) with different levels of liver dysfunction. Methods: This retrospective study included early HCC patients with Child-Pugh score (CPS) ≥ 7 cirrhosis who underwent percutaneous RFA at our center. The short-term efficacy of RFA was evaluated based on postoperative technical success, effectiveness, and complications, and long-term efficacy was evaluated based on recurrence-free survival (RFS) and overall survival (OS). The impact of liver dysfunction on both outcomes was explored. Results: In total, 176 patients (median age, 57 years; 149 males) were included. The technical success rate, technical effectiveness, and incidence of postoperative major complications were 96.6%, 97.7%, and 3.4%, respectively. There were no significant differences between the groups divided according to CPS. The 1-, 3-, and 5-year RFS rates were 54.1%, 28.8%, and 16.8%, respectively, no significant differences were observed between the groups divided by Child-Pugh score (p = 0.057), Albumin-Bilirubin grade (p = 0.170), or Model for End-stage Liver Disease score (p=0.210). The 1-, 3-, and 5-year OS rates were 91.3%, 67.1%, and 58.5%, respectively, and OS decreased as ALBI grade increased (p = 0.015). Multivariate Cox analysis demonstrated that male patient (hazard ratio, 2.31; p = 0.013) and recurrent HCC (hazard ratio, 2.347; p < 0.001) were independent predictive factors for RFS; hypertension (hazard ratio, 2.828; p = 0.042) and tumor number (hazard ratio, 2.445; p = 0.011) were independent predictive factors for OS, respectively. Conclusion: Radiofrequency ablation is safe and effective for early HCC patients with early hepatocellular carcinoma and liver dysfunction. Keywords: hepatocellular carcinoma, radiofrequency ablation, liver dysfunction, child-pugh score, albumin-bilirubin grade