Sung-Mi Jung1, Jong Man Kim1, Gyu-Seong Choi1, Choon Hyuck David Kwon1, Nam-Joon Yi2, Kwang-Woong Lee2, Kyung Suk Suh2, Jae-Won Joh3. 1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, South Korea. 2. Division of HBP Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea. 3. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, South Korea. jw.joh@samsung.com.
Abstract
BACKGROUND: Early recurrence after liver resection of hepatocellular carcinoma (HCC) has a great effect on the survival of patients. The aims of this study were to identify risk factors for early recurrence and to clarify whether early recurrence is related to patient survival rate. METHODS: We identified a total of 1010 patients with HCC recurrence after hepatic resection between 2009 and 2014 in Samsung Medical Center and Seoul National University Hospital. Inclusion criteria were preoperative solitary tumor Child-Pugh class A and curative hepatectomy. Early recurrence was defined as HCC recurrence < 1 year after surgery. RESULTS: A total of 628 patients were included in this study: 302 with early recurrence and 326 with late recurrence. Multivariate analysis showed that HCC grade 3 or 4, tumor size > 3 cm, and microvascular invasion were closely associated with early recurrence after liver resection for solitary HCC. When HCC recurred, the early recurrence group had large tumor size, increased tumor numbers and AFP levels, and high incidence of diffuse intrahepatic recurrence compared with the late recurrence group. The overall survival curve for the early recurrence group was lower than that for the late recurrence group (P < 0.001). Multivariate analysis demonstrated early recurrence was closely associated with patient survival. CONCLUSIONS: Patients with early recurrence had different characteristics compared to patients with late recurrence after hepatic resection in solitary HCC. Early detection of recurrence is necessary through active postoperative surveillance in hepatectomy patients with poor prognostic factors.
BACKGROUND: Early recurrence after liver resection of hepatocellular carcinoma (HCC) has a great effect on the survival of patients. The aims of this study were to identify risk factors for early recurrence and to clarify whether early recurrence is related to patient survival rate. METHODS: We identified a total of 1010 patients with HCC recurrence after hepatic resection between 2009 and 2014 in Samsung Medical Center and Seoul National University Hospital. Inclusion criteria were preoperative solitary tumorChild-Pugh class A and curative hepatectomy. Early recurrence was defined as HCC recurrence < 1 year after surgery. RESULTS: A total of 628 patients were included in this study: 302 with early recurrence and 326 with late recurrence. Multivariate analysis showed that HCC grade 3 or 4, tumor size > 3 cm, and microvascular invasion were closely associated with early recurrence after liver resection for solitary HCC. When HCC recurred, the early recurrence group had large tumor size, increased tumor numbers and AFP levels, and high incidence of diffuse intrahepatic recurrence compared with the late recurrence group. The overall survival curve for the early recurrence group was lower than that for the late recurrence group (P < 0.001). Multivariate analysis demonstrated early recurrence was closely associated with patient survival. CONCLUSIONS:Patients with early recurrence had different characteristics compared to patients with late recurrence after hepatic resection in solitary HCC. Early detection of recurrence is necessary through active postoperative surveillance in hepatectomy patients with poor prognostic factors.
Entities:
Keywords:
Early recurrence; Hepatectomy; Hepatocellular carcinoma; Tumor recurrence
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