Combined image-guided radiofrequency and iodine-125 seeds implantation in the treatment of recurrent hepatocellular carcinoma after hepatectomy.

Background: Currently, there is no consensus on the treatment of recurrent hepatocellular carcinoma (HCC) after hepatectomy. It is necessary to assess the efficacy and safety of radiofrequency ablation (RFA) combined with iodine-125 seeds implantation (RFA- ¹²⁵ I) in the treatment of recurrent HCC.
Methods: This study retrospectively analyzed the clinical data of patients with postoperative recurrence of HCC receiving RFA- ¹²⁵ I or RFA treatment from January 2013 to January 2023. Both RFA and ¹²⁵ I seeds implantation were performed under dual guidance of ultrasound and CT. Overall survival (OS), progression-free survival (PFS), recurrence, and complications were compared between the two groups.
Results: A total of 210 patients with recurrent HCC were enrolled in this study, including 125 patients in the RFA- ¹²⁵ I group and 85 patients in the RFA group. The RFA- ¹²⁵ I group showed a significantly better survival benefit than RFA group (median OS: 37 months vs. 16 months, P < 0.001; median PFS: 15 months vs. 10 months, P = 0.001). The uni- and multivariate analysis showed that RFA- ¹²⁵ I was a protective factor for OS and PFS. There were no procedure-related deaths and no grade 3 or higher adverse events in both groups.
Conclusions: RFA combined with ¹²⁵ I seeds implantation under dual guidance of ultrasound and CT is effective and safe for the treatment of HCC patients with recurrence after hepatectomy.
(© 2024. The Author(s).)