Risk factors for deterioration of long-term liver function after radiofrequency ablation therapy

doi:10.4254/wjh.v8.i13.597

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World Journal of Hepatology

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Retrospective Cohort Study

World J Hepatol. May 8, 2016; 8(13): 597-604
Published online May 8, 2016. doi: 10.4254/wjh.v8.i13.597

Risk factors for deterioration of long-term liver function after radiofrequency ablation therapy

Koichi Honda, Masataka Seike, Junya Oribe, Mizuki Endo, Mie Arakawa, Hiroki Syo, Masao Iwao, Masanori Tokoro, Junko Nishimura, Tetsu Mori, Tsutomu Yamashita, Satoshi Fukuchi, Toyokichi Muro, Kazunari Murakami

Koichi Honda, Masataka Seike, Junya Oribe, Mizuki Endo, Mie Arakawa, Hiroki Syo, Masao Iwao, Masanori Tokoro, Junko Nishimura, Tetsu Mori, Kazunari Murakami, Department of Gastroenterology, Faculty of Medicine, Oita University, Yufu-City, Oita 879-5593, Japan

Tsutomu Yamashita, Satoshi Fukuchi, Toyokichi Muro, De-partment of Gastroenterology and Hepatology, National Hospital Organization Oita Medical Center, Oita City, Oita 870-0263, Japan

Author contributions: Honda K wrote the manuscpipt; Honda K, Seike M, Oribe J, Endo M, Arakawa M, Syo H, Iwao M, Tokoro M, Nishimura J, Mori T, Yamashita T, Fukuchi S, Muro T and Murakami K performed the clinical work; Seike M and Murakami K revised the manuscript.

Institutional review board statement: This research was approved by the Ethics Committee of Oita University and Oita Medical Center.

Informed consent statement: This is a retrospective research. The additional informed consent from the patients does not apply.

Conflict-of-interest statement: We have no financial relation-ships to disclose.

Data sharing statement: No additional data are available.

Correspondence to: Koichi Honda, MD, PhD, Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu City, Oita 879-5593, Japan. hondak@oita-u.ac.jp

Telephone: +81-97-5866193 Fax: +81-97-5866194

Received: January 4, 2016
Peer-review started: January 8, 2016
First decision: March 1, 2016
Revised: March 13, 2016
Accepted: March 24, 2016
Article in press: March 25, 2016
Published online: May 8, 2016
Processing time: 120 Days and 7.1 Hours

Abstract

AIM: To identify factors that influence long-term liver function following radiofrequency ablation (RFA) in patients with viral hepatitis-related hepatocellular carcinoma.

METHODS: A total of 123 patients with hepatitis B virus- or hepatitis C virus-related hepatocellular car-cinoma (HCC) (n = 12 and n = 111, respectively) were enrolled. Cumulative rates of worsening Child-Pugh (CP) scores (defined as a 2-point increase) were examined.

RESULTS: CP score worsening was confirmed in 22 patients over a mean follow-up period of 43.8 ± 26.3 mo. Multivariate analysis identified CP class, platelet count, and aspartate aminotransferase levels as signi-ficant predictors of a worsening CP score (P = 0.000, P = 0.011 and P = 0.024, respectively). In contrast, repeated RFA was not identified as a risk factor for liver function deterioration.

CONCLUSION: Long-term liver function following RFA was dependent on liver functional reserve, the degree of fibrosis present, and the activity of the hepatitis condition for this cohort. Therefore, in order to maintain liver function for an extended period following RFA, suppression of viral hepatitis activity is important even after the treatment of HCC.

Keywords: Radiofrequency ablation; Hepatocellular carcinoma; Liver function; Hepatitis B; Hepatitis C

Core tip: This study was conducted to identify risk factors for liver function deterioration following radio-frequency ablation (RFA) in patients with hepatocellular carcinoma (HCC) and viral hepatitis. A total of 123 patients with hepatitis B virus- or hepatitis C virus-related HCC were enrolled. Cumulative rates of wor-sening Child-Pugh (CP) scores (defined as a 2-point increase) following RFA were examined. CP class, platelet count, and aspartate aminotransferase levels were identified as significant predictors of a worsening CP score. Suppression of viral hepatitis activity with anti-viral therapy is important even after the treatment of HCC in order to maintain liver function following RFA.