Low P2/MS value is an independent risk factor for early recurrence of hepatocellular carcinoma after radiofrequency ablation therapy.

BACKGROUND/AIMS: The influence of liver fibrosis on the recurrence of hepatocellular carcinoma after ablation therapy has not been fully elucidated. We previously reported that P2/MS [(platelet count [10(9)/L])2/(monocyte fraction[%] x segmented neutrophil fraction[%])] is an effective and noninvasive marker reflecting the degree of hepatic fibrosis. We aimed to evaluate the relationship between P2/MS value and hepatocellular carcinoma recurrence after radiofrequency ablation therapy in this study.

METHODOLOGY: Chronic hepatitis B patients who underwent RFA for hypervascular single hepatocellular carcinoma at Seoul National University Hospital between 2004 and 2007 were prospectively included. We identified the predictors of recurrence using Cox-regression model.

RESULTS

Fifty one patients were included. Median follow-up duration was 14.2 months. Twenty patients experienced tumor recurrence. Multivariable analyses showed that low P2/MS level [HR, 0.97 (95% CI, 0.95-0.99); p = 0.008] and alpha-fetoprotein level >100 ng/mL [HR, 8.65 (95% CI, 2.37-31.67); p = 0.001] were independent risk factors for tumor recurrence. Patients with P2/MS < 45.0 showed 3.68-fold (p = 0.048) increase in the risk of recurrence compared to those with P2/MS > or =45.0. However, tumor size, HBeAg and HBV DNA level failed to significantly affect the time-to-recurrence.

CONCLUSIONS

Our study suggests that low P2/MS value, which indicates high grade of hepatic fibrosis, is an independent risk factor for HBV-related hepatocellular carcinoma recurrence after radiofrequency ablation.