Combined Image-guided Radiofrequency and Iodine-125 Seeds Implantation in the Treatment of Recurrent Hepatocellular Carcinoma After Hepatectomy
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Background: Currently, there is no consensus on the treatment of recurrent hepatocellular carcinoma (HCC) after hepatectomy. It is necessary to assess the efficacy and safety of radiofrequency ablation (RFA) combined with iodine-125 seeds implantation (RFA-I) in the treatment of recurrent HCC.
Methods: This study retrospectively analyzed the clinical data of patients with postoperative recurrence of HCC receiving RFA-I or RFA treatment from January 2013 to January 2023. Both RFA and I seeds implantation were performed under dual guidance of ultrasound and CT. Overall survival (OS), progression-free survival (PFS), recurrence, and complications were compared between the two groups.
Results: A total of 210 patients with recurrent HCC were enrolled in this study, including 125 patients in the RFA-I group and 85 patients in the RFA group. The RFA-I group showed a significantly better survival benefit than RFA group (median OS: 37 months vs. 16 months, P < 0.001; median PFS: 15 months vs. 10 months, P = 0.001). The uni- and multivariate analysis showed that RFA-I was a protective factor for OS and PFS. There were no procedure-related deaths and no grade 3 or higher adverse events in both groups.
Conclusions: RFA combined with I seeds implantation under dual guidance of ultrasound and CT is effective and safe for the treatment of HCC patients with recurrence after hepatectomy.