title: Aggressive Intrasegmental Recurrence of Hepatocellular Carcinoma After Combined Transarterial Chemoembolization and Radiofrequency Ablation.
abstract: OBJECTIVE
  The goal of this study is to evaluate the outcomes of combined transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) in terms of the frequency of aggressive intrasegmental recurrence.
  
  
  METHODS
  Sixty-one patients (43 men and 18 women; mean [± SD] age, 65.8 ± 8.6 years; age range, 44-82 years) with 71 HCCs (mean [± SD] size, 2.8 ± 0.9 cm; range, 0.7-4.2 cm) underwent combined TACE and RFA. Aggressive intrasegmental recurrence was defined as initial tumor recurrence at least 6 months after treatment and the simultaneous development of recurrence of multiple (at least three) nodular or infiltrative tumors in the treated segment. Tumor contact with a thick (diameter, ≥ 3 mm) portal vein (i.e., periportal HCC) was evaluated. The frequency of aggressive intrasegmental recurrence, the local tumor progression (LTP) rate, and the complication rate were assessed.
  
  
  RESULTS
  The median follow-up period was 25.6 months (range, 6.1-75.5 months). Twenty-two HCCs (31%) were in contact with a thick portal vein. Aggressive intrasegmental recurrence was observed in one patient (representing 1.4% of all treated HCCs and 4.5% of periportal HCCs) after treatment of a 4.0-cm periportal HCC. The cumulative LTP rates at 1, 3, and 5 years were 6.7%, 21.0%, and 30.5%, respectively. The rate of major complications was 6.6%.
  
  
  CONCLUSIONS
  The frequency of aggressive intrasegmental recurrence after combined TACE and RFA for HCCs was very low.
authors: 1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul 135-710, Republic of Korea.
authors: Kyoung Doo
authors: KD
authors: Song
authors: 1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul 135-710, Republic of Korea.
authors: Min Woo
authors: MW
authors: Lee
authors: 1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul 135-710, Republic of Korea.
authors: Hyunchul
authors: H
authors: Rhim
authors: 1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul 135-710, Republic of Korea.
authors: Young-Sun
authors: YS
authors: Kim
authors: 1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul 135-710, Republic of Korea.
authors: Tae Wook
authors: TW
authors: Kang
authors: 1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul 135-710, Republic of Korea.
authors: Sung Wook
authors: SW
authors: Shin
authors: 1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro Gangnam-gu, Seoul 135-710, Republic of Korea.
authors: Sung Ki
authors: SK
authors: Cho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000628:therapy*; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D003287:Contrast Media; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
keywords: aggressive intrasegmental recurrence; hepatocellular carcinoma; radiofrequency ablation; transarterial chemoembolization