Ten-year survival and recurrence of hepatocellular cancer

Abstract

Aim: Long-term survival after hepatocellular cancer (HCC) is difficult to achieve likely related to recurrence. This study aimed to identify factors that were predictive of 10-year survival after the diagnosis of HCC. Methods:In a prospectively collected database of 1374 HCC cases , we identified 70 patients who survived over 10 years regardless of treatment. We then identified 164 patients in the entire cohort who either had liver resection or transplant, and died before 10 years. Demographics, tumor characteristics, treatment, recurrence and treatment of recurrence were compared.Results: Of the 10-year survivors, 36 underwent transplant, 27 had liver resection and 7 patients had only locoregional therapy. Compared to the non-survivors, the 10-year survivors were younger and had fewer comorbidities or recurrence, smaller tumor size, lower AST, ALT, AFP, platelets, neutrophil-to-lymphocyte ratio. Multivariate analysis showed only age and diabetes to be negative predictors. Recurrence occurred in 24 survivors (34.3%) with mean time to recurrence with standard deviation 57.1 ± 42.6 months compared to 80 non-survivors (48.7%) with mean time to recurrence of 15.3 ± 14.8 months. For hepatic resection, 10-year survivors had longer time to recurrence compared to non-survivors (median: 31.3 months). Conclusion:Long-term survivors mostly occur after resection or transplant, but 10% of our cohort survived 10 years with only locoregional therapy. Underlying health status maybe an important predictor of 10-year survival for patients receiving liver resections. Recurrence of HCC occurs in both 10-year survivors and non-survivors, but later recurrence with aggressive treatment of the recurrence may allow for 10-year survival.

Cost-Effectiveness of Adjuvant Immunotherapy With Cytokine-Induced Killer Cell for Hepatocellular Carcinoma Based on a Randomized Controlled Trial and Real-World Data

“…The long-term prognosis of patients with recurrent HCC remains poor because of deterioration of liver function with repeated recurrences even after curative treatment following early detection of HCC and during a successful regular surveillance program ( 5 ). Therefore, in the treatment of HCC, recurrence after curative treatment is an important indicator that is negatively related to long-term survival ( 6 ). To improve recurrence-free survival (RFS) in patients with HCC, several studies on adjuvant therapy have been conducted; however, none of these studies provide sufficient evidence of improvement except for antiviral treatment for HBV- or HCV-related HCC ( 3 ).…”

Molecular Mechanisms and Animal Models of HBV-Related Hepatocellular Carcinoma: With Emphasis on Metastatic Tumor Antigen 1

“…For decades, researchers have been exploring more sensitive biomarkers and developing more effective therapeutic strategies for HCC patients with a high risk of tumor recurrence. However, a great number of patients with HBV-HCC still suffer tumor recurrence [181,182]. Our woodchuck HCC study demonstrated that MTA1dE4, a major spliced variant of MTA1, may represent a more sensitive marker than total MTA1 in WHV-induced HCC [32].…”

Liver Resection Promotes (Regulates) Proinflammatory Cytokines in Patients with Hepatocellular Carcinoma

“…Moreover, LR is the mainstay of curative treatment and health-giving treatment for HCC, and the long-term survival of patients still remains undesirable since recurrence happens in about 54% of patients who underwent resection [ 38 , 39 ]. Recurrence after LR is highly associated with aggressive tumor characteristics, size of the tumor, presence of cirrhosis, Child–Pugh classification, alcohol consumption, and smoking [ 40 ].On the other hand, all HCC patients are not suitable for LR [ 41 ]. Ascites and uncorrectable coagulopathy are two major factors that reduce the number of candidates for surgery; furthermore, radiofrequency ablation has been suggested by the researcher as an alternative therapy for these CPT A and B HCC patients, and 3-year survival of patients reached up to 65% after it [ 42 ].…”