title: Recurrences of hepatocellular carcinoma following complete remission by transarterial chemoembolization or radiofrequency therapy: Focused on the recurrence patterns.
abstract: OBJECTIVE
  In this study, we analyzed the rates and patterns of recurrences in hepatocellular carcinoma (HCC) patients who had achieved complete remission (CR) by transarterial chemoembolization (TACE) or radiofrequency ablation (RFA), and also examined the differences of recurrence patterns between TACE-treated and RFA-treated groups.
  
  
  METHODS
  We followed 309 consecutive HCC patients who achieved CR following TACE (n = 220) or RFA (n = 89) for a median of 68 months. Recurrence patterns were classified as local recurrence and secondary tumor according to location of recurrence (≤2 cm and >2 cm from primary tumor).
  
  
  RESULTS
  Recurred HCC had been found in 231 out of 309 patients (75%) with CR by TACE or RFA; 112 local recurrences (48%), 100 secondary tumor (43%) and 19 both (9%). The cumulative recurrence rates at 1, 3 and 5 years were 22%, 64% and 79%, respectively. The overall recurrences at 1, 3 and 5 years following CR in the TACE-treated group was not different from those in the RFA-treated group (21%, 68% and 81% vs 26%, 56% and 84%, respectively; P = NS) However, the cumulative occurrence rates of local recurrence rates at 1, 3 and 5 years were significantly higher in the TACE-treated group compared to the RFA-treated group (15%, 53% and 65% vs 15%, 27% and 34%, respectively; P = 0.001).
  
  
  CONCLUSIONS
  Recurrence of HCC is very common, even following CR by TACE or RFA. Especially, local recurrences are very frequent in cases who achieved CR by TACE, which suggests that additional ablation therapy may be beneficial to prevent recurrences following CR by TACE.
authors: Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors: Wonhyeong
authors: W
authors: Park
authors: Young-Hwa
authors: YH
authors: Chung
authors: Jeong A
authors: JA
authors: Kim
authors: Young-Joo
authors: YJ
authors: Jin
authors: Don
authors: D
authors: Lee
authors: Ju Hyun
authors: JH
authors: Shim
authors: Danbi
authors: D
authors: Lee
authors: Kang Mo
authors: KM
authors: Kim
authors: Young-Suk
authors: YS
authors: Lim
authors: Han Chu
authors: HC
authors: Lee
authors: Yung Sang
authors: YS
authors: Lee
authors: Pyo Nyun
authors: PN
authors: Kim
authors: Kyu Bo
authors: KB
authors: Sung
keywords: hepatocellular carcinoma; radiofrequency ablation; recurrence; survival; transarterial chemoembolization