Risk factors for long-term prognosis in hepatocellular carcinoma after radiofrequency ablation therapy: The clinical implication of aspartate aminotransferase-platelet ratio index

Wei Yu Kao, Yi You Chiou, Hung Hsu Hung, Yi Hong Chou, Chien Wei Su, Jaw Ching Wu, Teh Ia Huo, Yi Hsiang Huang, Han Chieh Lin, Shou Dong Lee

Research output: Contribution to journalArticle

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Abstract

Objective: Percutaneous radiofrequency ablation (RFA) is one of the first-line curative therapies for hepatocellular carcinoma (HCC), but factors affecting the prognosis remain unclear. This study aimed to evaluate the prognostic factors associated with the prognosis in patients with HCC undergoing RFA. Methods: The study enrolled 190 treatment-naïve patients with HCC (<5 cm). Factors were analyzed in terms of overall survival and recurrence. Results: After a median follow-up of 30.7±17.5 months, 41 patients died and 149 patients were alive. Of the 112 patients who developed tumor recurrence, 61 had local recurrence and 51 had distant intrahepatic recurrence. The 5-year overall survival rate and recurrence rate were 65.5 and 73.6%, respectively. Factors associated with overall mortality were, age older than 65 years (P=0.019), aspartate aminotransferase-to-platelet ratio index (APRI) of more than 1 (P=0.015), prothrombin time international normalized ratio of more than 1.1 (P=0.013), multinodularity (P=0.024), and Child-Pugh grade B (P=0.036). Besides, multivariate analysis disclosed that APRI of more than 1 (P=0.002), multinodularity (P<0.001), and tumor size of more than 2 cm (P=0.002) predicted higher incidence of developing recurrence after RFA. Factors determining local recurrence were, age older than 65 years (P=0.030), APRI of more than 1 (P=0.003), multinodularity (P=0.019), and tumor size of more than 2 cm (P=0.015), whereas only APRI of more than 1 (P=0.013) and multinodularity (P<0.001) were independent risk factors predictive of intrahepatic distant metastasis. Conclusion: Both multinodularity and APRI are associated with overall survival and recurrence for patients with HCC after RFA therapy. Consequently, APRI seems to serve as a feasible marker for predicting the prognosis of patients with small HCC undergoing RFA.

Original languageEnglish
Pages (from-to)528-536
Number of pages9
JournalEuropean Journal of Gastroenterology and Hepatology
Volume23
Issue number6
DOIs
Publication statusPublished - Jun 1 2011
Externally publishedYes

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Aspartate Aminotransferases
Hepatocellular Carcinoma
Blood Platelets
Recurrence
Transaminases
Therapeutics
Neoplasms
International Normalized Ratio
Survival
Prothrombin Time
Multivariate Analysis
Survival Rate
Neoplasm Metastasis
Mortality
Incidence

Keywords

  • Aspartate aminotransferase-to-platelet ratio index
  • hepatocellular carcinoma
  • prognosis
  • radiofrequency ablation
  • recurrence

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Risk factors for long-term prognosis in hepatocellular carcinoma after radiofrequency ablation therapy : The clinical implication of aspartate aminotransferase-platelet ratio index. / Kao, Wei Yu; Chiou, Yi You; Hung, Hung Hsu; Chou, Yi Hong; Su, Chien Wei; Wu, Jaw Ching; Huo, Teh Ia; Huang, Yi Hsiang; Lin, Han Chieh; Lee, Shou Dong.

In: European Journal of Gastroenterology and Hepatology, Vol. 23, No. 6, 01.06.2011, p. 528-536.

Research output: Contribution to journalArticle

Kao, Wei Yu ; Chiou, Yi You ; Hung, Hung Hsu ; Chou, Yi Hong ; Su, Chien Wei ; Wu, Jaw Ching ; Huo, Teh Ia ; Huang, Yi Hsiang ; Lin, Han Chieh ; Lee, Shou Dong. / Risk factors for long-term prognosis in hepatocellular carcinoma after radiofrequency ablation therapy : The clinical implication of aspartate aminotransferase-platelet ratio index. In: European Journal of Gastroenterology and Hepatology. 2011 ; Vol. 23, No. 6. pp. 528-536.
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abstract = "Objective: Percutaneous radiofrequency ablation (RFA) is one of the first-line curative therapies for hepatocellular carcinoma (HCC), but factors affecting the prognosis remain unclear. This study aimed to evaluate the prognostic factors associated with the prognosis in patients with HCC undergoing RFA. Methods: The study enrolled 190 treatment-na{\"i}ve patients with HCC (<5 cm). Factors were analyzed in terms of overall survival and recurrence. Results: After a median follow-up of 30.7±17.5 months, 41 patients died and 149 patients were alive. Of the 112 patients who developed tumor recurrence, 61 had local recurrence and 51 had distant intrahepatic recurrence. The 5-year overall survival rate and recurrence rate were 65.5 and 73.6{\%}, respectively. Factors associated with overall mortality were, age older than 65 years (P=0.019), aspartate aminotransferase-to-platelet ratio index (APRI) of more than 1 (P=0.015), prothrombin time international normalized ratio of more than 1.1 (P=0.013), multinodularity (P=0.024), and Child-Pugh grade B (P=0.036). Besides, multivariate analysis disclosed that APRI of more than 1 (P=0.002), multinodularity (P<0.001), and tumor size of more than 2 cm (P=0.002) predicted higher incidence of developing recurrence after RFA. Factors determining local recurrence were, age older than 65 years (P=0.030), APRI of more than 1 (P=0.003), multinodularity (P=0.019), and tumor size of more than 2 cm (P=0.015), whereas only APRI of more than 1 (P=0.013) and multinodularity (P<0.001) were independent risk factors predictive of intrahepatic distant metastasis. Conclusion: Both multinodularity and APRI are associated with overall survival and recurrence for patients with HCC after RFA therapy. Consequently, APRI seems to serve as a feasible marker for predicting the prognosis of patients with small HCC undergoing RFA.",
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T1 - Risk factors for long-term prognosis in hepatocellular carcinoma after radiofrequency ablation therapy

T2 - The clinical implication of aspartate aminotransferase-platelet ratio index

AU - Kao, Wei Yu

AU - Chiou, Yi You

AU - Hung, Hung Hsu

AU - Chou, Yi Hong

AU - Su, Chien Wei

AU - Wu, Jaw Ching

AU - Huo, Teh Ia

AU - Huang, Yi Hsiang

AU - Lin, Han Chieh

AU - Lee, Shou Dong

PY - 2011/6/1

Y1 - 2011/6/1

N2 - Objective: Percutaneous radiofrequency ablation (RFA) is one of the first-line curative therapies for hepatocellular carcinoma (HCC), but factors affecting the prognosis remain unclear. This study aimed to evaluate the prognostic factors associated with the prognosis in patients with HCC undergoing RFA. Methods: The study enrolled 190 treatment-naïve patients with HCC (<5 cm). Factors were analyzed in terms of overall survival and recurrence. Results: After a median follow-up of 30.7±17.5 months, 41 patients died and 149 patients were alive. Of the 112 patients who developed tumor recurrence, 61 had local recurrence and 51 had distant intrahepatic recurrence. The 5-year overall survival rate and recurrence rate were 65.5 and 73.6%, respectively. Factors associated with overall mortality were, age older than 65 years (P=0.019), aspartate aminotransferase-to-platelet ratio index (APRI) of more than 1 (P=0.015), prothrombin time international normalized ratio of more than 1.1 (P=0.013), multinodularity (P=0.024), and Child-Pugh grade B (P=0.036). Besides, multivariate analysis disclosed that APRI of more than 1 (P=0.002), multinodularity (P<0.001), and tumor size of more than 2 cm (P=0.002) predicted higher incidence of developing recurrence after RFA. Factors determining local recurrence were, age older than 65 years (P=0.030), APRI of more than 1 (P=0.003), multinodularity (P=0.019), and tumor size of more than 2 cm (P=0.015), whereas only APRI of more than 1 (P=0.013) and multinodularity (P<0.001) were independent risk factors predictive of intrahepatic distant metastasis. Conclusion: Both multinodularity and APRI are associated with overall survival and recurrence for patients with HCC after RFA therapy. Consequently, APRI seems to serve as a feasible marker for predicting the prognosis of patients with small HCC undergoing RFA.

AB - Objective: Percutaneous radiofrequency ablation (RFA) is one of the first-line curative therapies for hepatocellular carcinoma (HCC), but factors affecting the prognosis remain unclear. This study aimed to evaluate the prognostic factors associated with the prognosis in patients with HCC undergoing RFA. Methods: The study enrolled 190 treatment-naïve patients with HCC (<5 cm). Factors were analyzed in terms of overall survival and recurrence. Results: After a median follow-up of 30.7±17.5 months, 41 patients died and 149 patients were alive. Of the 112 patients who developed tumor recurrence, 61 had local recurrence and 51 had distant intrahepatic recurrence. The 5-year overall survival rate and recurrence rate were 65.5 and 73.6%, respectively. Factors associated with overall mortality were, age older than 65 years (P=0.019), aspartate aminotransferase-to-platelet ratio index (APRI) of more than 1 (P=0.015), prothrombin time international normalized ratio of more than 1.1 (P=0.013), multinodularity (P=0.024), and Child-Pugh grade B (P=0.036). Besides, multivariate analysis disclosed that APRI of more than 1 (P=0.002), multinodularity (P<0.001), and tumor size of more than 2 cm (P=0.002) predicted higher incidence of developing recurrence after RFA. Factors determining local recurrence were, age older than 65 years (P=0.030), APRI of more than 1 (P=0.003), multinodularity (P=0.019), and tumor size of more than 2 cm (P=0.015), whereas only APRI of more than 1 (P=0.013) and multinodularity (P<0.001) were independent risk factors predictive of intrahepatic distant metastasis. Conclusion: Both multinodularity and APRI are associated with overall survival and recurrence for patients with HCC after RFA therapy. Consequently, APRI seems to serve as a feasible marker for predicting the prognosis of patients with small HCC undergoing RFA.

KW - Aspartate aminotransferase-to-platelet ratio index

KW - hepatocellular carcinoma

KW - prognosis

KW - radiofrequency ablation

KW - recurrence

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