Comparison of prognosis by viral etiology in patients with hepatocellular carcinoma after radiofrequency ablation

Ping-Hsien Chen, Wei-Yu Kao, Yi-You Chiou, Hung-Hsu Hung, Chien-Wei Su, Yi-Hong Chou, Teh-Ia Huo, Yi-Hsiang Huang, Wen-Chieh Wu, Yee Chao, Han-Chieh Lin, Jaw-Ching Wu
Annals of Hepatology 2013, 12 (2): 263-73

UNLABELLED: BACKGROUND; Radiofrequency ablation (RFA) has been performed as a first line curative treatment modality for patients with hepatocellular carcinoma (HCC) within the Milan criteria currently. However, prognosis of hepatitis B- and hepatitis C-related HCC after RFA remains debatable. This study aimed to assess the impact of viral etiology on the prognosis of HCC patients undergoing RFA.

MATERIAL AND METHODS: One hundred and ninety-two patients with positive serum HBV surface antigen (HBsAg) and negative serum antibody against HCV (anti-HCV) were enrolled as the B-HCC group and 165 patients with negative serum HBsAg and positive anti-HCV as the C-HCC group. Post-RFA prognoses were compared between the two groups using multivariate and propensity score matching analyses.

RESULTS: The B-HCC group had higher male-to-female ratio and better liver functional reserve than the C-HCC group. After a median follow-up of 23.0 ± 22.7 months, 55 patients died and 189 patients had tumor recurrence after RFA. The cumulative five-year survival rate was 75.9% and 69.5% in the B-HCC and C-HCC groups, respectively (p = 0.312), while the five-year recurrence-free survival rate was 19.0% and 26.6%, respectively (p = 0.490). After propensity-score matching, the B-HCC group still had comparable overall survival rate (p = 0.679) and recurrence-free survival rate (p = 0.689) to the C-HCC group. For 132 patients with Barcelona-Clinic Liver Cancer stage 0, the five-year overall survival and recurrence-free survival rates were also comparable between the two groups (p = 0.559 and p = 0.872, respectively).

CONCLUSION: Viral etiology is not essential for determining outcome in HCC patients undergoing RFA.

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