Despite the widespread use of PTA, to our knowledge there are no large studies that have investigated for factors predicting recurrence of p38 MAPK cancer HCC post PTA. Our primary aim therefore was to evaluate factors predicting the recurrence of HCC post PTA. Methods: Multi-centre retrospective study of patients treated with PTA (Radiofrequency
Ablation [RFA] and Microwave Ablation [MWA]) between Jan 2006 – Dec 2012. Subjects included were consecutive patients who had PTA with curative intent. Subjects who had other loco-regional therapies prior to PTA or with evidence of macrovascular invasion were excluded. Primary end point was the identification of factors predicting overall intrahepatic find more recurrence (IHR) using uni and multivariate analysis. A total 13 host, tumour and procedure related variables were analysed. IHR included both recurrence due to local tumour progression [LTP] and intrahepatic distant recurrence [IDR]. Secondary endpoints were rate of IHR (both LTP and IDR), recurrence free survival and the adverse event rate ( < 30 days from the procedure requiring hospitalization). Results: Ninety-three subjects [mean age ( ± SD): 62.7 ( ± 10.1) years, 77.4% males] were included in the study. 91.2% had cirrhosis and HCV (29%), HBV (18.3%) accounted for majority of the liver
disease. 11.8% had more than one nodule Rucaparib cost and the overall mean ( ± SD) tumour diameter was 26.1 (13.3) mm. 73.1% had RFA and the mean ( ± SD) follow-up duration was 421.3 ( ± 396.9) days. Overall IHR rate was 55.9% during the follow-up period with LTP in 33.3%, IDR in 29% and 6.5% had both. Overall median ( ± SE) recurrence free survival was 422 ( ± 48) days. Poorly differentiated HCC was the only independent predictor of overall IHR [HR (95% CI): 6.1 (1.9–19.2), p = 0.002], LTP [9.8 (2.3–41.3, p = 0.002]
and IDR [5.3 (1.2–22.9), p = 0.03]. There was a trend towards early IHR in patients having MWA compared to RFA [median ( ± SE) days: 399 ( ± 32) v 554 ( ± 111) days, p = 0.06). This was more evident in single tumours less than 30 mm where the recurrence was significantly earlier in those having MWA [median ( ± SE) days: 399 ( ± 37) v 568 ( ± 120) days, p = 0.02]. Overall, 11.8% had an adverse event and this was higher in the MWA group compared to RFA but, not significant (25% v 9.7%, p = 0.14). There were no procedure related deaths in this cohort. Conclusion: Poorly differentiated HCC is an important, independent predictor of overall IHR, LTP and IDR post PTA. Trends towards earlier recurrence in patients having MWA, together with a higher adverse event rates in the MWA group raise concerns about the efficacy and safety of this technique relative to RFA in real world settings and require further study.