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

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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
Issue number6
Publication statusPublished - Jun 1 2011
Externally publishedYes



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

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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