Low Intrahepatic Distant Recurrence Rate Following RFA Using Linear Mode in Patients With Hepatocellular Carcinoma

TL;DR

Using a linear mode during radiofrequency ablation for liver cancer reduces the chance of cancer returning in other parts of the liver.

Contribution

The study identifies the linear RFA mode as a novel factor associated with reduced intrahepatic distant recurrence in hepatocellular carcinoma.

Findings

The linear RFA mode was associated with a lower intrahepatic distant recurrence rate compared to the nonlinear mode.

High platelet count and low AFP-L3 levels were also linked to reduced recurrence in the linear mode group.

Survival rates and complication rates were similar between the two RFA modes.

Abstract

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Radiofrequency ablation (RFA) can be utilized in elderly patients and those with cirrhosis with reduced functional liver reserve as it is less invasive. The arfa RFA system is the first system to offer a linear mode. However, the differences in performance between the linear and existing (nonlinear) modes remain unknown.

This retrospective observational study compared the performance of the linear (linear group) and nonlinear RFA modes (nonlinear group) in HCC.

Data of 425 patients with one to three HCC tumors measuring ≤ 3 cm who underwent RFA were analyzed. Recurrence (local and distant), survival, and complication rates between the linear and nonlinear groups were determined.

The intrahepatic distant recurrence rate was lower in the linear group than in the nonlinear group (p < 0.05). Multivariate analysis showed that the high platelet count, low AFP‐L3 levels, initial case, and linear mode were independent factors associated with a low intrahepatic distant recurrence rate following RFA. Liver disease‐related survival, HCC survival, overall survival of the initial HCC, local recurrence, and complication rates were comparable between the linear and nonlinear groups.

The linear mode of the RFA protocol results in a lower intrahepatic distant recurrence rate compared with the nonlinear protocol.

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