Pre-operative Low Platelet Level Indicates Poor Prognosis In Hepatocellular Carcinoma Patients Within Milan Criteria Treated By Radiofrequency Ablation

Objective The aim of this study was to investigate the prognostic factor for hepatocellular carcinoma(HCC)patients within Milan criteria who underwent radiofrequency ablation(RFA)therapy.Methods Two hundred and twenty-three HCC patients fulfilling Milan criteria,who was underwent RFA in the Affiliated Hospital of Qingdao University from January 2011 to December 2015,were enrolled in this retrospective study.The Kaplan-Meier analysis and Cox proportional hazards regression model were used to investigate the prognostic factor for the disease-free survival(DFS)and over-all survival(OS).Results The median follow-up was 37.9 months,in which 27(12.1%)patients died and 86(39.9%)patients was recurrent.The 1-,2-,3-and 5-year DFS rates and OS rates were87.9%,74.0%,65.0%,61.9% and 99.6%,95.5%,91.5,87.9%,respectively.Univariate analysis showed that tumor number and pre-operative platelet(PLT)level were prognostic factors for DFS,while pre-operative PLT level and alcohol abuse were prognostic factors for OS(P<0.05).Multivariate analysis indicated that multiple tumor(HR 1.735,95%CI 1.016-2.962,P = 0.043)and pre-operative PLT<100×109/L(HR1.619,95%CI 1.054-2.487,P = 0.028)were independent risk factors for DFS.And PLT<100×109/L(HR 3.391,95%CI 1.511-7.608,P = 0.003)was the only independent risk factor for OS.The 1-,2-,3-and 5-year DFS rates were 85.0%,68.8%,56.3%,50.0%in PLT decreasing group and 89.5%,76.9%,69.9%,68.5% in non-PLT decreasing group.The 1-,2-,3-and 5-year OS rates of patients were 100%,93.8%,86.3%,77.5% in PLT decreasing group and 99.3%,96.5%,94.4%,93.7% in non-PLT decreasing group,respectively.Conclusions Pre-operative PLT level may be an effective prognostic factor related to OS and DFS for HCC patients within Milan criteria underwent RFA treatment.