Abstract

Background

The impact of prolonged post-ablation fever (PAF) defined as persistent fever > 24 h after radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) had not been described before. This study aims to investigate the impact of prolonged PAF on early tumor recurrence in HCC patients after RFA.

Methods

From 2013 to 2015, a total of 135 patients with HCC meeting Milan criteria and all the tumors having confirmed complete ablation after RFA were enrolled. Study endpoint was any HCC recurrence within 1 year after ablation. Cox regression analysis was applied for multivariate analysis to determine the independent predictors of 1-year tumor recurrence.

Results

Post-ablation fever occurred in 42 (31.1%) patients after RFA, while prolonged PAF was found in 22 (16.3%) patients. Fifty-eight (42.8%) patients occurred any tumor recurrence within 1 year after complete ablation. Patients with prolonged PAF had a significantly higher rate of HCC recurrence within 1 year (72.7% vs. 37.1%, p = 0.002) and had a significantly shorter time-to-recurrence interval (19.6 vs. 40.5 months, Log rank test, p = 0.002) than those who had no prolonged PAF. Multivariate analysis by Cox regression showed the previous HCC recurrence history (aHR: 1.792, p = 0.0284), baseline AFP > 20 ng/ml (aHR: 1.868, p = 0.0211) and prolonged PAF (aHR: 2.092, p = 0.0138) were associated with early recurrence.

Conclusions

Prolonged PAF may associate with early HCC recurrence after complete ablation by RFA. Patients with prolonged PAF need to be more clinical attentions.

中文翻译：

---

消融后长期发热可能预示着射频消融后肝细胞癌的一年肿瘤复发。

摘要

背景

以前没有描述过长时间消融后发热（PAF）对肝细胞癌（HCC）射频消融（RFA）后持续发烧> 24 h的影响。这项研究旨在探讨延长PAF对RFA后HCC患者早期肿瘤复发的影响。

方法

从2013年到2015年，总共有135例符合米兰标准的HCC患者入选，所有纳入RFA后已确认完全消融的肿瘤均入选。研究终点为消融后1年内任何HCC复发。Cox回归分析用于多变量分析，以确定1年肿瘤复发的独立预测因子。

结果

射频消融后42例（31.1％）患者发生消融后发烧，而22例（16.3％）患者发现PAF延长。完全消融后1年内有58例（42.8％）患者发生任何肿瘤复发。PAF延长的患者在1年内HCC复发率显着更高（72.7％vs. 37.1％，p  = 0.002），并且复发间隔时间明显更短（19.6 vs. 40.5个月，对数秩检验，p  = 0.002）比那些没有延长PAF的人。通过Cox回归进行的多变量分析显示先前的HCC复发史（aHR：1.792，p  = 0.0284），基线AFP> 20 ng / ml（aHR：1.868，p  = 0.0211）和延长的PAF（aHR：2.092，p = 0.0138）与早期复发相关。

结论

RFA完全消融后，延长的PAF可能与早期HCC复发有关。PAF延长的患者需要更多的临床关注。