Clinical Features of Recurrence After Hepatic Resection for Early-Stage Hepatocellular Carcinoma and Long-Term Survival Outcomes of Patients with Recurrence: A Multi-institutional Analysis

Yao, Lan-Qing; Chen, Zhenliang; Feng, Zihan; Diao, Yong-Kang; Li, Chao; Sun, Haiying; Zhong, Jian‐Hong; Chen, Ting‐Hao; Gu, Wei‐Min; Zhou, Ya-Hao; Zhang, Wanguang; Wang, Hong; Zeng, Yongyi; Wu, Han; Wang, Mingda; Xu, Xin‐Fei; Pawlik, Timothy M.; Lau, Wan Yee; Shen, Feng; Yang, Tian

doi:10.1245/s10434-022-11454-y

Cited by 38 publications

(24 citation statements)

References 39 publications

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“…4,5 Yao et al reported that satellite nodules are also an independent risk factor for postoperative recurrence of HCC. 6 The authors should use more stringent propensity score matching and other statistical methods to minimize the differences in baseline characteristics between the two groups.…”

Section: To the Editormentioning

confidence: 99%

“…Second, the authors did not report some other factors that may affect the recurrence of HCC in the two groups of patients, including preoperative alpha-fetoprotein level, surgical margin, intraoperative blood transfusion, and postoperative adjuvant therapy. 6 Transarterial chemoembolization (TACE) is often recommended as an adjuvant therapy J o u r n a l P r e -p r o o f after surgery for HCC patients of BCLC stage 0 or A combined with high-risk recurrence factors, such as multiple tumors and microvascular invasion. Studies have shown that TACE can reduce the risk of recurrence in patients with liver cancer after radical surgery.…”

Section: To the Editormentioning

confidence: 99%

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HBsAg seroclearance reduces the risk of late recurrence in HBV-related HCC

Jin

Yang

2022

Journal of Hepatology

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Section: To the Editormentioning

confidence: 99%

Section: To the Editormentioning

confidence: 99%

HBsAg seroclearance reduces the risk of late recurrence in HBV-related HCC

Jin

Yang

2022

Journal of Hepatology

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“…Endorsed by the American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver (EASL), the Barcelona Clinic Liver Cancer (BCLC) staging system indicates that solitary HCC without macrovascular invasion and distant metastasis (BCLC stage 0/A), regardless of tumor size, should be considered for curative-intent surgical treatment including hepatectomy and liver transplantation, which may provide a chance of cure (3)(4)(5). Unfortunately, long-term survival after hepatectomy for HCC is still compromised by high rates of postoperative recurrence, which can range from 40% to 60% within 5 years after surgery even among patients with solitary HCC (4,(6)(7)(8)(9)(10). Therefore, a better understanding of clinicopathological characteristics and recurrence-related risk factors for patients with solitary HCC is needed.…”

Section: Introductionmentioning

confidence: 99%

Grading severity of microscopic vascular invasion was independently associated with recurrence and survival following hepatectomy for solitary hepatocellular carcinoma

Yao¹,

Li²,

Diao³

et al. 2024

Hepatobiliary Surg Nutr

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Background: Hepatectomy is the preferred treatment for solitary hepatocellular carcinoma (HCC) without macrovascular invasion and distant metastasis, but long-term survival remains unsatisfactory in certain patients. We sought to identify whether the grading severity of microscopic vascular invasion (MVI) was associated with recurrence and survival among patients with solitary HCC.Methods: Consecutive patients who underwent hepatectomy for solitary HCC were identified from a multicenter prospectively-collected database. Patients were categorized into three groups according to the MVI grading system proposed by the Liver Cancer Pathology Group of China: M0 (no MVI), M1 (1-5 sites of MVI occurring ≤1.0 cm away from the tumor), and M2 (>5 sites occurring ≤1.0 cm or any site occurring >1 cm away from the tumor). Recurrence-free survival (RFS) and overall survival (OS) were compared among the groups.Results: Among 227 patients, 97 (57.4%), 83 (30.4%), and 47 (12.1%) patients had M0, M1, and M2, respectively. Median RFS rates among patients with M0, M1, and M2 were 38.3, 35.1, 11.6 months, respectively, while OS rates were 66.8, 62.3, 30.6 months, respectively (both P<0.001). Multivariate Coxregression analyses demonstrated that both M1 and M2 were independent risk factors for RFS (hazard ratio

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“…Several previous studies found that some BCLC-B HCC patients undergoing LR had favorable long-term overall survival (OS) rates (5-year OS rates: 50%-75%); however, these selected patients still had high postoperative recurrence rates (2-year recurrence rate: ≥ 50%), which means that many of these patients had good recurrence-to-death survival (RTDS)[ 7 , 8 ]. Both recurrence patterns and treatments after recurrence can affect the RTDS of HCC patients who develop recurrence after LR[ 9 - 11 ]. However, previous studies did not analyze the main reasons why these selected patients had good RTDS, which may affect the judgment of the role of LR in these patients[ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Postoperative outcomes and recurrence patterns of intermediate-stage hepatocellular carcinoma dictated by the sum of tumor size and number

Hu¹,

Yang²,

Leng³

et al. 2022

World J Gastroenterol

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BACKGROUND The selection criteria for Barcelona Clinic Liver Cancer (BCLC) intermediate-stage hepatocellular carcinoma (HCC) patients who would truly benefit from liver resection (LR) remain undefined. AIM To identify BCLC-B HCC patients more suitable for LR. METHODS We included patients undergoing curative LR for BCLC stage A or B multi-nodular HCC (MNHCC) and stratified BCLC-B patients by the sum of tumor size and number (N + S). Overall survival (OS), recurrence-free survival (RFS), recur-rence-to-death survival (RTDS), recurrence patterns, and treatments after recurrence in BCLC-B patients in each subgroup were compared with those in BCLC-A patients. RESULTS In total, 143 patients who underwent curative LR for MNHCC with BCLC-A ( n = 25) or BCLC-B ( n = 118) were retrospectively analyzed. According to the N + S, patients with BCLC-B HCC were divided into two subgroups: BCLC-B1 (N + S ≤ 10, n = 83) and BCLC-B2 (N + S > 10, n = 35). Compared with BCLC-B2 patients, those with BCLC-B1 had a better OS (5-year OS rate: 67.4% vs 33.6%; P < 0.001), which was comparable to that in BCLC-A patients (5-year OS rate: 67.4% vs 74.1%; P = 0.250), and a better RFS (median RFS: 19 mo vs 7 mo; P < 0.001), which was worse than that in BCLC-A patients (median RFS: 19 mo vs 48 mo; P = 0.022). Further analysis of patients who developed recurrence showed that both BCLC-B1 and BCLC-A patients had better RTDS (median RTDS: Not reached vs 49 mo; P = 0.599), while the RTDS in BCLC-B2 patients was worse (median RTDS: 16 mo vs not reached, P < 0.001; 16 mo vs 49 mo, P = 0.042). The recurrence patterns were similar between BCLC-B1 and BCLC-A patients, but BCLC-B2 patients had a shorter recurrence time and a higher proportion of patients had recurrence with macrovascular invasion and/or extrahepatic metastasis, both of which were independent risk factors for RTDS. CONCLUSION BCLC-B HCC patients undergoing hepatectomy with N + S ≤ 10 had mild recurrence patterns and excellent OS similar to those in BCLC-A MNHCC patients, and LR should be considered in these patients.

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Clinical Features of Recurrence After Hepatic Resection for Early-Stage Hepatocellular Carcinoma and Long-Term Survival Outcomes of Patients with Recurrence: A Multi-institutional Analysis

Cited by 38 publications

References 39 publications

HBsAg seroclearance reduces the risk of late recurrence in HBV-related HCC

HBsAg seroclearance reduces the risk of late recurrence in HBV-related HCC

Grading severity of microscopic vascular invasion was independently associated with recurrence and survival following hepatectomy for solitary hepatocellular carcinoma

Postoperative outcomes and recurrence patterns of intermediate-stage hepatocellular carcinoma dictated by the sum of tumor size and number

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