title: Use of transient elastography to predict de novo recurrence after radiofrequency ablation for hepatocellular carcinoma.
abstract: OBJECTIVE
  Liver stiffness (LS) measurement using transient elastography can accurately assess the degree of liver fibrosis, which is associated with the risk of the development of hepatocellular carcinoma (HCC). We investigated whether LS values could predict HCC de novo recurrence after radiofrequency ablation (RFA).
  
  
  METHODS
  This retrospective, multicenter study analyzed 111 patients with HCC who underwent RFA and LS measurement using transient elastography between May 2005 and April 2011. All patients were followed until March 2013 to monitor for HCC recurrence.
  
  
  RESULTS
  This study included 76 men and 35 women with a mean age of 62.4 years, and the mean LS value was 21.2 kPa. During the follow-up period (median 22.4 months), 47 (42.3%) patients experienced HCC de novo recurrence, and 18 (16.2%) died. Patients with recurrence had significantly more frequent liver cirrhosis, more frequent history of previous treatment for HCC, higher total bilirubin, larger spleen size, larger total tumor size, higher tumor number, higher LS values, and lower platelet counts than those without recurrence (all P<0.05). On multivariate analysis, together with previous anti-HCC treatment history, patients with LS values >13.0 kPa were at significantly greater risk for recurrence after RFA, with a hazard ratio (HR) of 3.115 (95% confidence interval [CI], 1.238-7.842, P<0.05). Moreover, LS values independently predicted the mortality after RFA, with a HR of 9.834 (95% CI, 1.148-84.211, P<0.05), together with total bilirubin.
  
  
  CONCLUSIONS
  Our data suggest that LS measurement is a useful predictor of HCC de novo recurrence and overall survival after RFA.
authors: Department of Internal Medicine, Yonsei University College of Medicine, Catholic University of Korea, Seoul, Korea.
authors: Sang Hoon
authors: SH
authors: Lee
authors: Department of Internal Medicine, Yonsei University College of Medicine, Catholic University of Korea, Seoul, Korea ; Institute of Gastroenterology, Yonsei University College of Medicine, Catholic University of Korea, Seoul, Korea ; Liver Cirrhosis Clinical Research Center, College of Medicine, Catholic University of Korea, Seoul, Korea.
authors: Seung Up
authors: SU
authors: Kim
authors: Department of Internal Medicine, College of Medicine, Catholic University of Korea, Seoul, Korea.
authors: Jeong Won
authors: JW
authors: Jang
authors: Department of Internal Medicine, College of Medicine, Catholic University of Korea, Seoul, Korea.
authors: Si Hyun
authors: SH
authors: Bae
authors: Department of Internal Medicine, Yonsei University College of Medicine, Catholic University of Korea, Seoul, Korea ; Liver Cirrhosis Clinical Research Center, College of Medicine, Catholic University of Korea, Seoul, Korea.
authors: Sanghun
authors: S
authors: Lee
authors: Department of Internal Medicine, Yonsei University College of Medicine, Catholic University of Korea, Seoul, Korea ; Institute of Gastroenterology, Yonsei University College of Medicine, Catholic University of Korea, Seoul, Korea ; Liver Cirrhosis Clinical Research Center, College of Medicine, Catholic University of Korea, Seoul, Korea.
authors: Beom Kyung
authors: BK
authors: Kim
authors: Department of Internal Medicine, Yonsei University College of Medicine, Catholic University of Korea, Seoul, Korea ; Institute of Gastroenterology, Yonsei University College of Medicine, Catholic University of Korea, Seoul, Korea ; Liver Cirrhosis Clinical Research Center, College of Medicine, Catholic University of Korea, Seoul, Korea.
authors: Jun Yong
authors: JY
authors: Park
authors: Department of Internal Medicine, Yonsei University College of Medicine, Catholic University of Korea, Seoul, Korea ; Institute of Gastroenterology, Yonsei University College of Medicine, Catholic University of Korea, Seoul, Korea ; Liver Cirrhosis Clinical Research Center, College of Medicine, Catholic University of Korea, Seoul, Korea.
authors: Do Young
authors: DY
authors: Kim
authors: Department of Internal Medicine, Yonsei University College of Medicine, Catholic University of Korea, Seoul, Korea ; Institute of Gastroenterology, Yonsei University College of Medicine, Catholic University of Korea, Seoul, Korea ; Liver Cirrhosis Clinical Research Center, College of Medicine, Catholic University of Korea, Seoul, Korea.
authors: Sang Hoon
authors: SH
authors: Ahn
authors: Department of Internal Medicine, Yonsei University College of Medicine, Catholic University of Korea, Seoul, Korea ; Institute of Gastroenterology, Yonsei University College of Medicine, Catholic University of Korea, Seoul, Korea ; Liver Cirrhosis Clinical Research Center, College of Medicine, Catholic University of Korea, Seoul, Korea.
authors: Kwang-Hyub
authors: KH
authors: Han
keywords: fibroscan; hepatocellular carcinoma; liver stiffness; radiofrequency ablation; recurrence