Risk factors for long-term prognosis in hepatocellular carcinoma after radiofrequency ablation therapy: the clinical implication of aspartate aminotransferase-platelet ratio index

Objective Percutaneous radiofrequency ablation (RFA) is one of the first-line curative therapies for hepatocellular carcinoma (HCC), but factors affecting the prognosis remain unclear. This study aimed to evaluate the prognostic factors associated with the prognosis in patients with HCC undergoing RFA. Methods The study enrolled 190 treatment-naive patients with HCC (< 5 cm). Factors were analyzed in terms of overall survival and recurrence. Results After a median follow-up of 30.7 ±17.5 months, 41 patients died and 149 patients were alive. Of the 112 patients who developed tumor recurrence, 61 had local recurrence and 51 had distant intrahepatic recurrence. The 5-year overall survival rate and recurrence rate were 65.5 and 73.6%, respectively. Factors associated with overall mortality were, age older than 65 years (P=0.019), aspartate aminotransferase-to-platelet ratio index (APRI) of more than 1 (P=0.015), prothrombin time international normalized ratio of more than 1.1 (P=0.013), multinodularity (P=0.024), and Child-Pugh grade B (P= 0 . 036 ). Besides, multivariate analysis disclosed that APRI of more than 1 (P= 0.002), multinodularity (P< 0.001), and tumor size of more than 2 cm (P= 0.002) predicted higher incidence of developing recurrence after RFA. Factors determining local recurrence were, age older than 65 years (P=0.03 0 ), APRI of more than 1 (P=0.003), multinodularity (P=0.019), and tumor size of more than 2cm (P= 0 .0 1 5), whereas only APRI of more than 1 (P= 0 . 013 ) and multinodularity (P