title: Influence of serum HBV DNA load on recurrence of hepatocellular carcinoma after treatment with percutaneous radiofrequency ablation.
abstract: BACKGROUND
  High serum load of hepatitis B virus (HBV) deoxyribonucleic acid (DNA) is a strong risk factor of hepatocellular carcinoma (HCC) development, independent of hepatitis B e antigen, serum alanine aminotransferase level, and liver cirrhosis. We evaluated whether serum HBV DNA load is associated with the risk of recurrence of HBV-related HCC treated with radiofrequency ablation (RFA).
  
  
  METHODS
  The study population was 69 consecutive patients with HBV-related HCC treated locally completely with RFA between January 2000 and September 2007. The risk factors for HCC recurrence were analyzed based on laboratory data, including serum HBV DNA load, together with tumor size and number using univariate and multivariate proportional hazard regression analyses.
  
  
  RESULTS
  HCC recurrence was observed in 42 of 69 patients during the median observation period of 1.5 years. Cumulative recurrence rates at 1, 3, and 5 years were 26.5, 57.8, and 74.3%, respectively. In univariate analysis, albumin (<3.5 g/dl), platelet count (<150 × 10(3)/mm(3)), prothrombin activity (PT) (<70%), Child-Pugh class B, serum HBV DNA load (>4.0 log10 copies/ml), and tumor number (>3) were associated with the recurrence at p ≤ 0.15. Multivariate Cox regression analysis with stepwise variable selection showed that the tumor number (risk ratio, 4.63; 95% CI, 1.50-14.25, P = 0.0076), low PT (3.39, 1.52-5.78, P = 0.0029), and high HBV DNA load (2.67, 1.16-6.14, P = 0.021) were independent risk factors for HCC recurrence.
  
  
  CONCLUSIONS
  Serum HBV DNA load is associated with the risk of recurrence of HBV-related HCC after RFA.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan, tadagotou-gi@umin.ac.jp.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Goto
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Yoshida
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Tateishi
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Enooku
authors.forename: Eriko
authors.initials: E
authors.lastname: Goto
authors.forename: Takahisa
authors.initials: T
authors.lastname: Sato
authors.forename: Takamasa
authors.initials: T
authors.lastname: Ohki
authors.forename: Ryota
authors.initials: R
authors.lastname: Masuzaki
authors.forename: Jun
authors.initials: J
authors.lastname: Imamura
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Shiina
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
authors.forename: Masao
authors.initials: M
authors.lastname: Omata