Radiofrequency ablation and transarterial chemoembolisation as first-line treatment for recurrent hepatocellular carcinoma or isolated intrahepatic recurrent hepatocellular carcinoma in transplanted livers

Aim To evaluate the efficacy of radiofrequency ablation (RFA) and transarterial chemoembolisation (TACE) as a first-line treatment for isolated intrahepatic recurrent hepatocellular carcinoma (IIR-HCC) after liver transplantation (LT). Materials and methods This retrospective study was approved by the institutional review board. Between January 2005 and January 2015, 588 consecutive patients underwent LT for the treatment of HCC. Among them, 27 patients with IIR-HCCs after LT who were treated with RFA ( n= 6) or TACE ( n= 21) as a first-line treatment were retrospectively included in this study. Disease-free and overall survival rates were estimated using the Kaplan–Meier method. Risk factors affecting these outcomes were assessed with Cox regression models. Results Except for the total number of recurrent tumours and time-to-tumour recurrence after LT, baseline characteristics were not significantly different between the groups. The 2-year disease-free survival rates for RFA and TACE (20% versus 14%, respectively; p= 0.180) and 4-year overall survival rates (33% versus 25%, respectively; p= 0.065) were not significantly different between groups. In addition, the types of treatment were not associated with disease-free or overall survival in multivariate analyses. Conclusion TACE may be an effective treatment comparable to RFA in patients with IIR-HCC after LT when RFA is not feasible.