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

Sijie Xiao,1,* Yuzheng Yan,1,* Huaqiang Bi,1 Tengqian Tang,1 Kai Feng,1 Feng Xia,1 Chunlin Tang,2 Kuansheng Ma,1 Qiang Wang3 1Department of Hepatobiliary Surgery, The First Affiliated Hospital (Southwest Hospital) of Army Medical University, Chongqing, People’s Republic of China; 2Department of Ultrasound, The First Affiliated Hospital (Southwest Hospital) of Army Medical University, Chongqing, People’s Republic of China; 3Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden*These authors contributed equally to this workCorrespondence: Kuansheng Ma, Department of Hepatobiliary Surgery, The First Affiliated Hospital (Southwest Hospital) of Army Medical University, Chongqing, People’s Republic of China, Email [email protected] Chunlin Tang, Department of Ultrasound, The First Affiliated Hospital (Southwest Hospital) of Army Medical University, Chongqing, People’s Republic of China, Email [email protected]: 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