PERCUTANEOUS RADIOFREQUENCY ABLATION AS A FIRST LINE TREATMENT FOR HEPATOCELLULAR CARCINOMA – PROSPECTIVE COHORT STUDY FROM A TERTIARY CARE CENTRE, KERALA, INDIA

Introduction There is scarcity of Indian data on the effectiveness of radiofrequency ablation (RFA) as the first line therapy. The aim of the study was to evaluate the recurrence rate after RFA as the first-line therapy for early-stage hepatocellular carcinoma (HCC). Materials and Methods: Hospital based prospective cohort study. The study period was from September 2016 to august 2018, during which 61 patients with early stage HCC without coagulopathy were included into the study after obtaining written consent. Image guided RFA was performed as a first-line treatment for early HCCs with a maximum diameter of 3 cm or solitary tumour with a diameter of <5 cm. Follow up was performed on day 1 post procedure to identify residue and for a period of 2 years after which results were analyzed for tumor recurrence, as well as recurrence-free survival time. Chi Square test was used to analyse the association of recurrence, event free survival and local tumour progression. Kaplan Meir survival analysis was used to find the event free survival. Results: The recurrence rate was 54.1%. The Local Tumour Progression rate was 36.36%; and the Intra hepatic distant recurrence rate was 51.51%. The overall 2-year survival was 96.73%. The event free survival for 2 years was 17.87 months (95% CI 16.0, 19.6 months). Significant predictive factors for poor recurrence free survival were age>65 years, AFP levels >200 ng/ml and multiple tumour. Conclusion: Percutaneous RFA can be used as first-line treatment for early stage HCC.