Nguyen N, Rode A, Trillaud H, Aubé C, Manichon AF, Hocquelet A, Paisant A, Dao T, Nahon P, Ganne-Carrié N, Blaise L, Cauchy F, Sutter O, Séror O, Nault JC
Liver International, Décembre 2021
Background & aims: Long-term outcomes after percutaneous radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD) have been poorly studied. We aim to determine the outcomes after multibipolar RFA in these patients compared to other etiologies as well as the prognostic impact of metabolic syndrome (MS).
Methods: Patients who underwent multibipolar RFA as first treatment for HCC within Milan criteria (2008-2018) were enrolled in this multicenter retrospective cohort from four tertiary centers in France. The association of MS and NAFLD with adverse events and outcomes after percutaneous RFA were assessed using Kaplan-Meier method, log-rank test and uni/multivariate analysis with the Cox models.
Results: Among 520 patients, 390 patients (75%) had at least one component of MS including obesity (30%) and 95% had cirrhosis. Sixty-two patients (12.6%) had NAFLD-HCC, 225 (45.5%) had alcohol related-HCC, 36 (7.3%) had HBV-HCC and 171 (34.6%) had HCV-HCC. Patients with NAFLD-HCC were significantly older (median age 72.6 years, p<0.001), more obese (median BMI 30.3 kg/m2 , p<0.001) and had more components of MS. Patients with NAFLD-HCC achieved a median overall survival (OS) of 79 months (1-year, 3-year, and 5-year OS of 90%, 71% and 59%). There were no differences in morbidity, tumor recurrence and OS among patients with NAFLD-HCC versus other etiologies as well as no prognostic impact of metabolic components.
Conclusions: Percutaneous multibipolar RFA is an efficient treatment in HCC patients with NAFLD or metabolic syndrome and achieved similar long-term oncological outcomes compared to other etiologies.