Scholarlink

Aim <p>The incidence of intrahepatic distant recurrence (IDR) of hepatocellular carcinoma (HCC) still remains high after radiofrequency ablation (RFA). However, serum alpha-fetoprotein (AFP) has insufficient screening power. This study aimed to identify risk factors for IDR in patients with post-RFA HCC.</p> Method <p>A total of 112 patients with early-stage HCC who underwent RFA were divided into the IDR (<i>n</i> = 51) and non-IDR groups (<i>n</i> = 61). Serum samples were analyzed within 2&#xa0;months after RFA.</p> Results <p>The mean follow-up duration was 30.1&#xa0;months. The recurrence-free survival rates at 1, 3, and 5&#xa0;years were 20.8%, 42.4%, and 54.2%, respectively. The 1- and 5-year overall survival rates were 97.3% and 87.3%, respectively. Univariate and multivariate analyses revealed that the neutrophil-to-lymphocyte ratio [NLR, hazard ratio (HR) 2.40; 95% confidence interval (CI) 1.44–3.99] and lens culinaris agglutinin a-reactive fraction of alpha-fetoprotein (AFP-L3, (HR 1.02; 95% CI 1.01–1.04) were independently associated with post-RFA IDR. The cumulative recurrence rates at 5&#xa0;years in the high NLR (≥ 2.24) and high AFP-L3 (≥ 0.2&#xa0;ng/mL) groups were significantly higher than those in the low NLR (&lt; 2.24) and low AFP-L3 (&lt; 0.2&#xa0;ng/mL) groups, respectively. The predictive accuracies of NLR, AFP-L3, and a composite index based on AFP-L3, and NLR for IDR were 66.2% (37.3% sensitivity, 95.1% specificity), 64.3% (47.1% sensitivity, 80.3% specificity), and 75.6% (68.6% sensitivity, 75.4% specificity), respectively.</p> Conclusion <p>The combined model had significantly better prediction performance than either NLR or AFP-L3 alone. The NLR combined with an absolute AFP-L3 level is an effective marker for IDR in patients with post-RFA HCC.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Risk Factors for Intrahepatic Distant Recurrence After Radiofrequency Ablation for Hepatocellular Carcinoma

  • 期刊论文

  • 发表日期：

    2025年3月12日

查看全文
  • Yuki Tsuji,
  • Tadashi Namisaki,
  • Hiroaki Takaya,
  • Naoki Nishimura,
  • Ryuichi Noguchi,
  • Shohei Asada,
  • Akihiko Shibamoto,
  • Takahiro Kubo,
  • Satoshi Iwai,
  • Fumimasa Tomooka,
  • Aritoshi Koizumi,
  • Takuya Matsuda,
  • Misako Tanaka,
  • Nobuyuki Yorioka,
  • Takashi Inoue,
  • Yukihisa Fujinaga,
  • Norihisa Nishimura,
  • Koh Kitagawa,
  • Shinya Sato,
  • Kosuke Kaji,
  • Kiyoshi Asada,
  • Akira Mitoro,
  • Hitoshi Yoshiji

摘要

Aim

The incidence of intrahepatic distant recurrence (IDR) of hepatocellular carcinoma (HCC) still remains high after radiofrequency ablation (RFA). However, serum alpha-fetoprotein (AFP) has insufficient screening power. This study aimed to identify risk factors for IDR in patients with post-RFA HCC.

Method

A total of 112 patients with early-stage HCC who underwent RFA were divided into the IDR (n = 51) and non-IDR groups (n = 61). Serum samples were analyzed within 2 months after RFA.

Results

The mean follow-up duration was 30.1 months. The recurrence-free survival rates at 1, 3, and 5 years were 20.8%, 42.4%, and 54.2%, respectively. The 1- and 5-year overall survival rates were 97.3% and 87.3%, respectively. Univariate and multivariate analyses revealed that the neutrophil-to-lymphocyte ratio [NLR, hazard ratio (HR) 2.40; 95% confidence interval (CI) 1.44–3.99] and lens culinaris agglutinin a-reactive fraction of alpha-fetoprotein (AFP-L3, (HR 1.02; 95% CI 1.01–1.04) were independently associated with post-RFA IDR. The cumulative recurrence rates at 5 years in the high NLR (≥ 2.24) and high AFP-L3 (≥ 0.2 ng/mL) groups were significantly higher than those in the low NLR (< 2.24) and low AFP-L3 (< 0.2 ng/mL) groups, respectively. The predictive accuracies of NLR, AFP-L3, and a composite index based on AFP-L3, and NLR for IDR were 66.2% (37.3% sensitivity, 95.1% specificity), 64.3% (47.1% sensitivity, 80.3% specificity), and 75.6% (68.6% sensitivity, 75.4% specificity), respectively.

Conclusion

The combined model had significantly better prediction performance than either NLR or AFP-L3 alone. The NLR combined with an absolute AFP-L3 level is an effective marker for IDR in patients with post-RFA HCC.