Rapid progression of hepatocellular carcinoma after Radiofrequency Ablation

Table 1 Characteristics of 87 cirrhotic HCC patients treated with RFA

Characteristic	n	(%)
Gender
Male	71	81.6
Female	16	18.4
Ethiology of cirrhosis
HCV related	46	52.9
HBV related	11	12.6
HBV+HCV	3	3.4
Alcoholic	24	27.7
Other causes	3	3.4
Child-Pugh classification
A	48	55.2
B	39	44.8
C	0	0
CLIP score
0	25	28.7
1	42	48.3
2	19	21.8
4	1	1.2
Number of lesions
Single	53	60.9
Multiple	34	39.1
Morphology of HCC
Infiltrating	18	17.3
Noninfiltrating	86	82.7
Alfa-fetoprotein level
< 200 kU/L	79	90.8
200 kU/L	8	9.1

Table 2 Treatment-related complications occurred in 130 pro-cedure

	Events n (%)
Minor complications	13 (10)
Fever (> 38 °C) and moderate pain (5-6 d)	10 (7.7)
Right pleural effusion	2 (1.5)
Cutaneous burn	1 (0.8)
Major complications	8 (6.1)
Rapid tumor progression	4 (2.9)
Bacterial endocarditis	1 (0.8)
Neoplastic seeding	1 (0.8)
Peritoneal bleeding	1 (0.8)
Hepatic decompensation	1 (0.8)

Table 3 Caracteristics of four patients with rapid tumor progression after RFA

Gender, age, etiology	Tumor size (cm)		Location	Differentiation
1. Male, 66 yr, alcohol	3.5	V segment	Near right portal trunka	Poor
2.Male, 75 yr, HCV	3.8	VI segment	Near segmental portal brancha	Poor
3. Male, 59 yr, HBV, HCV	4.5	VII segment	Near cava vein	Poor
3.Male, 62 yr, HBV	4.5	IV segment	Near segmental portal brancha	Moderate

^a: ≤ 1 cm from main or segmental portal branches.

Table 4 Risk factors for rapid tumor progression in 87 patients

Variables	No tumor progression (83)	Tumor progression (4)	P value
Child-Pugh class
A/B	45/38	3/1	0.41
CLIP score
0/1/2/4	25/40/17/1	0/2/2/0	0.43
Number lesions
Single/multiple	50/33	2/2	0.68
AFP value
< 200/≥ 200 kU/L	77/6	2/2	0.04
Tumor size
< 3 cm/3-5 cm/5-7 cm	10/59/14	0/4/0	0.45
Tumor morphology
Infiltrating/	15/68	1/3	0.72
noninfiltrating
Portal vein thrombosis
No/main portal	71/1/3	3/0/1	0.17
branch/sectorial
Tumor location
Peripheral/near	60/23	1/3	0.04
main portal
Treatment
Duration RFA (min)	27.7±13.7	25.6±7.5	0.40
Number insertions	2.0±1.3	1.7±0.9	0.33