Background : Radio-frequency ablation (RFA) is a less invasive treatment than hepatic resection for patients with a damaged liver. The aim of the current study was to clarify prognostic factors for patients with hepatocellular carcinoma (HCC) who underwent RFA on a recurrent lesion in the liver after curative hepatectomy.

Methods: Among 625 HCC patients who had undergone curative hepatectomy between 2000 and 2010, 42 received RFA on primary recurrent lesion after hepatectomy and were enrolled in this study. Clinical factors involved in poor prognosis were investigated.

Results: Median age of patients was 72. Liver cirrhosis determined by pathological F4 was confirmed in 16 (38%) patients. Tumor diameter was invariably no more than 3 cm at recurrence. In 42 patients with recurrent HCC, no clinical factors available at the first hepatectomy were associated with poor prognosis. At recurrence, des-γ-carboxy prothrombin (DCP) ≥ 40 mAu/ml and recurrence within 1 year of hepatectomy were associated with poor overall survival. Multivariate analysis revealed that these factors were independently associated with poor overall survival.

Conclusion: For HCC patients treated by RFA at intrahepatic recurrence after curative hepatectomy, abnormal serum DCP level and recurrence within 1 year may be poor prognostic factors and thereby need careful follow-up even if RFA is successful.