Table 3.
Characteristics of studies involving treatment of recurrent hepatocellular carcinoma by radiofrequency ablation
| Ref. | n | Tumors (n) | Tumor size (cm) | Radiologic response necrosis | PLR→RFA interval (mo) | Follow-up after RFA (mo) |
Overall survival |
Disease-free survival |
Main findings | ||||
| 1-yr | 3-yr | 5-yr | 1-yr | 3-yr | 5-yr | ||||||||
| Nicoli et al[100] | 5 | - | - | - | 43 (31.0-61.0) | 25.5 (-) | - | 60.0% | - | - | 20.0% | - | RFTA is the first-choice treatment in the management of intrahepatic recurrence |
| Choi et al[101] | 45 | 53 | 2.1 (0.8-4.0) | 87.0% (46.0/53.0) | 23 (10.0-40.0) | 18.0 (2.0-47.0) | 82.0% | 54.0% | - | 57.0% | 34.0% | - | Percutaneous RFA is effective and safe for intrahepatic recurrent HCC after hepatectomy. Serum alpha-fetoprotein level before RFA and resected tumor size were significant prognostic predictors of long-term survival |
| Lu et al[102] | 72 | 124 | 2.4 (0.9-7.0) | 96.0% (119.0/124.0) | 27.9 (2.0-75.9) | 21.0 (1.0-215.2) | 70.0% | 55.0% | 28.0% | 22.0% | 95.0% | 83.0% | Percutaneous thermal ablative therapies were particularly suitable for recurrent HCC and improved long-term survival |
| Schindera et al[103] | 35 | 61 | 1.7 (0.5-5.3) | 85.5% (54.0/61.0) | 18 (1.0-65.0) | - | 76.0% | 45.0% | - | - | - | - | Percutaneous RFA is effective and safe for recurrent HCC after hepatectomy, with a good overall patient survival rate |
| Yang et al[104] | 41 | 76 | 3.8 (2.0-6.6) | 93.4% (71.0/76.0) | - | 24.5 (1.0-96.0) | 73.0% | 41.0% | - | 46.0% | 24.0% | - | Percutaneous RFA is effective and safe for recurrent hepatic tumors after previous partial hepatectomy |
| Choi et al[105] | 102 | 119 | 2.0 (0.8-5.0) | 93.3% (111.0/119.0) | 35.6 (7.0-83.0) | 22.3 (1.3-125.7) | 93.9% | 65.7% | 51.6% | 52.2% | 21.3% | 7.2% | RFA is effective and safe for recurrent HCC after hepatectomy and is more effective in late than in early recurrence |
| Liang et al[106] | 66 | 88 | - | 93.9% (62.0/66.0) | 21.1 (2.4-69.4) | - | 76.6% | 48.6% | 39.9% | - | - | - | Percutaneous RFA is as effective as repeat hepatectomy for recurrent small HCC. Percutaneous RFA has an advantage over repeat hepatectomy in terms of being less invasive |
| Chan et al[107] | 45 | - | 2.2 (0.8-6.0) | 87.0% (46.0/53.0) | 35.6 (7.0-83.0) | - | 83.7% | 43.1% | 29.1% | 32.2% | 12.4% | 9.3% | Repeat resection and RFA attained similar survival benefits in the management of recurrent HCC after hepatectomy. The high repeatability of RFA and its ability to be delivered percutaneously render it a preferred treatment option for selected patients |
| Eisele et al[108] | 27 | - | 2.8 (-) | - | - | 21.0 (-) | 96.0% | 62.0% | 32.0% | 51.0% | 30.0% | 11.0% | Overall survival and disease-free survival were not significantly different between patients treated by RFA and repeat resection. There was, however, a tendency toward longer tumor-free survival in the resected patients |
HCC: Hepatocellular carcinoma; PLR: Previous liver resection; RFA: Radiofrequency ablation; RFTA: Radiofrequency thermal ablation.