Abstract
Few studies have reported models predicting early recurrence in patients undergoing radiofrequency ablation (RFA) for early-stage hepatocellular carcinoma (HCC). We aim to present such a model. We enrolled 791 patients with newly diagnosed early-stage HCC (i.e., within Milan criteria) and Child–Pugh class A liver disease undergoing percutaneous RFA. Survival analysis was performed using the Kaplan − Meier method with the log-rank test. Cox proportional hazards analysis was used to identify prognostic factors associated with early recurrence (i.e., recurrence within two years after RFA). Internal validation was performed with a bootstrapping method. Early recurrence was identified in 270 (34.1%) patients. Multivariate analysis showed that multiple tumors (HR = 1.450; 95% CI = 1.098–1.914; p = 0.009), alpha-fetoprotein (AFP) ≥ 20 ng/ml (HR = 1.614; 95% CI = 1.268–2.054; p < 0.001), and Model for End-Stage Liver Disease (MELD) score (HR = 1.026; 95% CI = 1.003–1.049; p = 0.025) were associated with early recurrence. We constructed a predictive model with these variables. This model provided three risk strata for recurrence-free survival (RFS): low risk, intermediate risk, and high risk, with two-year RFS of 63%, 57%, and 40%, respectively (p < 0.001). Calibration plots showed overall high agreement between the predictions made by the model and observed outcomes. In conclusion, we developed a risk prediction model to predict early recurrence in patients undergoing RFA for early-stage HCC.