title: Local Recurrence after Radiofrequency Ablation of Hepatocellular Carcinoma: Treatment Choice and Outcome.
abstract: OBJECTIVE
  Radiofrequency ablation (RFA) has been proven effective for treating small hepatocellular carcinoma (HCC) nodules. However, post-RFA local recurrence is a major factor limiting prognosis. Up to now, there is no consensus on a standardized treatment strategy for these local recurrences. The aim of this study is to evaluate the outcomes of salvage treatments for RFA-related local recurrence.
  
  
  METHODS
  From May 2008 to June 2013, a total of 112 patients with HCC were detected with local recurrence after RFA. Among them, 94 patients received sequential treatments in our hospital, including salvage resection (SR) (n = 24), salvage liver transplantation (n = 2), repeated RFA (n = 62), and transarterial chemoembolization (TACE) (n = 6). We evaluated the treatment outcomes of patients by salvage surgery (SS), RFA, and TACE.
  
  
  RESULTS
  The median follow-up time was 32 months. After treatment, local recurrence was eradicated in 82 of 94 patients (87.2%). The complete response (CR) rate in the RFA group was 90.3% (56/62), while it was 100% (26/26) in the SS group (P = 0.175) and 0% (0/6) in the TACE group. When analysis confined to patients with CR, the 1- and 3-year disease-free survival (DFS) rates were 57.7 and 20.2% in the SS group, and 41.7 and 28.6% in the RFA group, respectively (P = 0.640). The 1- and 3-year overall survival (OS) rates were 93.3 and 69.1% in the SS group, and 78.6 and 57.5% in the RFA group, respectively (P = 0.251).
  
  
  CONCLUSIONS
  Repeated RFA is the first treatment choice for patients with post-RFA local recurrence. SS should be considered when RFA failed or is inapplicable.
authors.affiliation: Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Xie
authors.forename: Chunlin
authors.initials: C
authors.lastname: Jiang
authors.forename: Zhengwei
authors.initials: Z
authors.lastname: Peng
authors.forename: Baoxian
authors.initials: B
authors.lastname: Liu
authors.forename: Wenjie
authors.initials: W
authors.lastname: Hu
authors.forename: Ye
authors.initials: Y
authors.lastname: Wang
authors.forename: Manxia
authors.initials: M
authors.lastname: Lin
authors.forename: Mingde
authors.initials: M
authors.lastname: Lu
authors.forename: Ming
authors.initials: M
authors.lastname: Kuang
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D012086:Reoperation; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate; D016896:Treatment Outcome