Prediction model for early intrahepatic recurrence after hepatectomy for patients with hepatocellular carcinoma: an implication for adjuvant treatment

Abstract

Introduction: Efficacy of hepatic resection for hepatocellular carcinoma (HCC) is limited by the high incidence of intrahepatic recurrence, which is related to intrahepatic tumor metastasis in early postoperative period. Method: This study aims to develop and test a prediction model for early intrahepatic recurrence after curative hepatic resection for HCC. From 1989 to 2014, 1411 patients with HCC underwent curative hepatic resection. They were divided into development group (n = 706) and validation group (n = 705). Risk factors for early intrahepatic recurrence (< 18 months after hepatic resection) were identified by multivariate analysis and a prediction scoring model was developed and validated internally. Results: Five clinicopathologic factors were identified as independent risk factors (bilobar disease, multiple tumors >3, cirrhosis, microvascular invasion and satellite nodules). A risk scoring model based on the odds ratio of these factors was obtained. Patients were stratified into low risk (points 0 e 4), intermediate risk (points 5 e 9) and high risk (points > 9) groups with significantly different early tumor recurrence rates (25.6% vs. 51.4% vs. 73.5%). This risk scoring model was internally validated. The accuracy of this prediction model as assessed by receiver operating curves showed the area under the curve was 69.7% with 95% confidence interval (65.6% e 73.9%) (P < 0.001). Conclusion: The derived prediction scoring model can accurately predict the chance of early intrahepatic recurrence after curative hepatic resection for HCC. This

Early Versus Late Hepatocellular Carcinoma Recurrence After Transplantation: Predictive Factors, Patterns, and Long-term Outcome

“…47 In our cohort, 10 of 14 patients (71.4%) had strong predictors of early recurrence, either bilobar tumor and/or MVI. Hong et al 32 reported similar results, that tumor size >5 cm in the explanted liver was a significant risk factor for early HCC recurrence within 6 months from LT. Bilobar tumor has been shown as an associated risk factor for HCC recurrence after LT. 9, 15 Ng et al 48 identified bilobar disease as one of the independent risk factors to develop a prediction model for early intrahepatic recurrence after curative hepatic resection for HCC. But very few reports looked clearly at the aspect of early versus late HCC recurrence after LT. 18,19,32 According to most of the available guidelines, poorly differentiated tumors and presence of MVI in the explanted liver are considered as significant predictive factors for HCC recurrence after LT.…”