Long‐ versus short‐interval follow‐up after resection of hepatocellular carcinoma: a retrospective cohort study

Abstract

BackgroundAverage postoperative follow-up intervals vary in patients undergoing hepatocellular carcinoma (HCC) resection because of limited evidence regarding the optimal interval. We aimed to compare the associations of long-versus short-interval follow-up with survival and recurrence in risk-stratified HCC patients.MethodsWe performed a retrospective cohort study between 2007 and 2014. In total, 1227 patients treated by curative resection of Barcelona Clinic Liver Cancer stage A or B HCC were stratified as having a low (n = 865) or high (n = 362) risk of early recurrence (within the first 2 years after resection) based on prognostic factors identified by the least absolute shrinkage and selection operation algorithm. Patients were further classified into long-interval (every 4–6 months) and short-interval (every 2–4 months) follow-up subgroups based on follow-up within 2 years after resection (low risk, long vs. short: n = 390 vs. n = 475; high-risk, long vs. short: n = 149 vs. n = 213).ResultsThe short-interval follow-up did not prolong overall survival in either the low-risk (hazard ratio [HR] = 1.152; 95% confidence interval [CI] 0.720–1.843) or high-risk (HR = 1.213; 95% CI 0.702–2.094) patients. Early recurrence occurred in 401 patients. For high-risk patients, the short-interval follow-up subgroup exhibited smaller intrahepatic recurrence than did the long-interval group (2.6 vs. 3.5 cm, respectively, P = 0.045). However, no significant difference in the rate of Barcelona Clinic Liver Cancer stage 0/A recurrence was found between the long- and short-interval follow-up groups in either low- or high-risk patients (63.1% vs. 68.2%, respectively, P = 0.580; 31.3% vs. 41.5%, respectively, P = 0.280). The rate of curative intent treatment for recurrence (34.5% vs. 39.7%, respectively, P = 0.430; 14.6% vs. 20.3%, respectively, P = 0.388) was also similar between the follow-up groups for low- and high-risk patients.ConclusionsShortening the postoperative follow-up interval from every 4–6 months to every 2–4 months within the first 2 years after resection did not increase the rate of curative intent treatment or prolong the overall survival of patients with Barcelona Clinic Liver Cancer stage A or B HCC.

Resection vs. Sorafenib for Hepatocellular Carcinoma With Macroscopic Vascular Invasion: A Real World, Propensity Score Matched Analytic Study

“…Enhanced CT or MRI was performed every 2 or 3 months after surgery or sorafenib according to subsequent therapies. Follow-ups were performed as previously described (14), unless judged otherwise by the treating physicians.…”

Stereotactic Body Radiotherapy as a Salvage Therapy after Incomplete Radiofrequency Ablation for Hepatocellular Carcinoma: A Retrospective Propensity Score Matching Study

“…Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide, and the incidence of HCC has doubled in the past 20 years, making it the second global leading cause of cancer-related deaths [1,2,3]. According to guidelines of the European Society for Medical Oncology (ESMO) and American Association for the Study of Liver Disease (AASLD), liver transplantation, hepatectomy, thermal tumor ablation, and radiotherapy are the most acceptable treatment strategies for early stage HCC [4,5].…”

Postoperative imaging surveillance for hepatocellular carcinoma: How much is enough?

“…In particular, data on postoperative imaging among patients with HCC has been discordant and has suffered from several shortcomings. [31][32][33] The current study was, therefore, important as we quantified the annual use of imaging among patients who underwent treatment for HCC, as well as determined whether a survival benefit was discernible in patients undergoing more intense surveillance imaging. Of note, there was a decreasing trend in the utilization of surveillance imaging over the study period examined.…”