Abstract
This study aimed to explore the predictive value of contrast-enhanced ultrasound (CEUS) parameters combined with inflammatory-nutritional indices for recurrence and survival following radiofrequency ablation (RFA) in early-stage hepatocellular carcinoma (HCC). It also sought to provide evidence-based personalized treatment strategies for clinical practice. A retrospective analysis was conducted on the clinical data of 263 HCC patients who underwent RFA at Henan Provincial People's Hospital from January 2021 to June 2022. Comprehensive data on tumor angiogenesis and hemodynamics were collected using CEUS, and the Prognostic Inflammatory and Nutritional Index (PINI) was calculated. Multivariate Cox analysis was performed to assess the predictive efficacy of these parameters for tumor recurrence and long-term survival. The study found that a low PINI score was associated with a higher risk of postoperative tumor recurrence and mortality. Among the CEUS parameters, time to peak, peak intensity, enhancement rate, and PINI were significantly correlated with tumor recurrence and patient survival. The combined scoring system, integrating CEUS parameters and PINI (CEUS-PINI), effectively distinguished different risk groups and was significantly associated with both recurrence-free survival and overall survival. In conclusion, the combination of CEUS parameters and PINI provides a simple, non-invasive prognostic tool that helps predict recurrence risk and survival outcomes following RFA in early-stage HCC. This combined assessment system can aid in the early identification of high-risk patients and facilitate the development of postoperative monitoring and management strategies.