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[10⁹/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>100ng/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≥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.