Methods

A total of 101 patients (April 2007 to August 2010) underwent RFA for residual or recurrent HCC after TACE. We analyzed their long-term outcomes and predictive factors.

Results

The overall survival rates after RFA were 93.1%, 65.4%, and 61.0% at 1, 3, and 5 years, respectively. Predictive factors for favorable overall survival were Child-Pugh class A (hazard ratio [HR], 3.45; p= 0.001), serum α-fetoprotein (AFP) level< 20 ng/mL (HR, 2.90; p= 0.02), and recurrent tumors after the last TACE (HR, 3.14; p= 0.007). The cumulative recurrence-free survival rate after RFA at 6 months was 50.1%. Predictive factors for early recurrence (within 6 months) were serum AFP level 20 ng/mL (HR, 3.02; p< 0.001), tumor size 30 mm at RFA (HR, 2.90; p= 0.005), and nonresponse to the last TACE (HR, 2.13; p= 0.013).

Conclusions

Patients with recurrent or residual HCC who undergo prior TACE show a favorable overall survival, although their tumors seem to recur early and frequently. While good liver function, a low serum AFP level, and recurrent tumors were independent predictive factors for a favorable overall survival, poor response to TACE, a high serum AFP level, and large tumors are associated with early recurrence.