Factors associated with increased risk of peritoneal seeding after radiofrequency ablation for hepatocellular carcinoma

Purpose To evaluate the incidence, risk factors, and prognosis associated with peritoneal seeding after percutaneous radiofrequency ablation (RFA) for HCC, focusing on viable tumors after previous locoregional treatment, including TACE and RFA. Methods Exactly 290 patients (mean age, 67.9 years ± 9....

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Published in:Abdominal imaging 2023-10, Vol.48 (10), p.3243-3252
Main Authors: Ryu, Hwaseong, Kim, Tae Un, Lee, Jun Woo, Jeon, Ung Bae, Kim, Jin Hyeok, Jang, Joo Yeon, Yoon, Ki Tae, Hong, Young Mi
Format: Article
Language:English
Subjects:
Ablation
Chemoembolization
Confidence intervals
Gastroenterology
Health hazards
Hepatobiliary
Hepatocellular carcinoma
Hepatology
Imaging
Liver cancer
Medical prognosis
Medicine
Medicine & Public Health
Metastases
Metastasis
Metastatic seeding
Peritoneal seeding
Peritoneum
Prognosis
Radio frequency
Radiofrequency ablation
Radiology
Regression analysis
Risk factors
Statistical analysis
Subgroups
Survival
Tumors
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Summary:Purpose To evaluate the incidence, risk factors, and prognosis associated with peritoneal seeding after percutaneous radiofrequency ablation (RFA) for HCC, focusing on viable tumors after previous locoregional treatment, including TACE and RFA. Methods Exactly 290 patients (mean age, 67.9 years ± 9.74; 223 men) with 383 HCCs (mean size, 15.9 mm ± 5.49) who underwent RFA between June 2012 and December 2019 were included in this retrospective study. Among them, 158 had history of previous treatment (mean number, 1.3 ± 1.8) with 109 viable HCCs. Cumulative seeding after RFA was estimated using the Kaplan–Meier method. Independent factors affecting seeding were investigated using multivariable Cox proportional hazards regression analysis. Results Median follow-up was 1175 days (range: 28–4116). Seeding incidence was 4.1 (12/290) and 4.7% (17/383) per patient and tumor, respectively. The median time interval between RFA and detection of seeding was 785 days (range: 81–1961). Independent risk factors for seeding included subcapsular tumor location (hazard ratio [HR] 4.2; 95% confidence interval [CI] 1.4, 13.0; p  = 0.012) and RFA for viable HCC after previous locoregional treatment (HR 4.5; 95% CI 1.7, 12.3; p  = 0.003). Subgroup analysis for viable tumors, revealed no significant difference in cumulative seeding rates between the TACE and RFA groups ( p  = 0.078). Cumulative overall survival rates differed significantly between patients with and without seeding metastases ( p  
ISSN:2366-0058
2366-004X
2366-0058
DOI:10.1007/s00261-023-03987-x