Risk factors for very early recurrence of hepatocellular carcinoma: a retrospective review

Abstract Background The inflammation indexes in blood routine play an essential role in evaluating the prognosis of patients with hepatocellular carcinoma, but the effect on early recurrence has not been clarified. The study aimed to investigate the risk factors of early recurrence (within 2 years) and recurrence-free survival after curative hepatectomy and explore the role of inflammatory indexes in predicting early recurrence. Methods The baseline data of 161 patients with hepatocellular carcinoma were analyzed retrospectively. The optimal cut-off value of the inflammatory index was determined according to the Youden index. Its predictive performance was compared by the area under the receiver operating characteristic curve. Logistic and Cox regression analyses were used to determine the risk factors of early recurrence and recurrence-free survival. Results The area under the curve of monocyte to lymphocyte ratio (MLR) for predicting early recurrence was 0.700, which was better than systemic inflammatory response index (SIRI), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and systemic immune-inflammatory index (SII). MLR, tumour size, tumour differentiation and BCLC stage are all risk factors for early recurrence and recurrence-free survival of HCC. Combining the above four risk factors to construct a joint index, the area under the curve for predicting early recurrence was 0.829, which was better than single MLR, tumour size, tumour differentiation and BCLC stage. Furthermore, with the increase of risk factors, the recurrence-free survival of patients is worse. Conclusion The combination of MLR and clinical risk factors is helpful for clinicians to identify high-risk patients with early recurrence and carry out active postoperative adjuvant therapy to improve the prognosis of patients.

Download Full-text

Risk Factors for Early Recurrence of Single Lesion Hepatocellular Carcinoma After Curative Resection

World Journal of Surgery ◽

10.1007/s00268-016-3529-7 ◽

2016 ◽

Vol 40 (10) ◽

pp. 2466-2471 ◽

Cited By ~ 17

Author(s):

Mitsugi Shimoda ◽

Kazuma Tago ◽

Takayuki Shiraki ◽

Shozo Mori ◽

Masato Kato ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Curative Resection ◽

Early Recurrence ◽

Single Lesion

Download Full-text

Risk factors for early recurrence after surgical resection for hepatocellular carcinoma

The Korean Journal of Hepatology ◽

10.3350/kjhep.2008.14.3.371 ◽

2008 ◽

Vol 14 (3) ◽

pp. 371 ◽

Cited By ~ 10

Author(s):

Ui Jun Park ◽

Yong Hoon Kim ◽

Koo Jeong Kang ◽

Tae Jin Lim

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Surgical Resection ◽

Early Recurrence

Download Full-text

Clinicopathological Risk Factors for Recurrence within One Year after Initial Hepatectomy for Hepatocellular Carcinoma

The American Surgeon ◽

10.1177/000313481107700516 ◽

2011 ◽

Vol 77 (5) ◽

pp. 572-578 ◽

Cited By ~ 11

Author(s):

Michihiro Hayashi ◽

Tetsunosuke Shimizu ◽

Fumitoshi Hirokawa ◽

Yoshihiro Inoue ◽

Koji Komeda ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

High Risk ◽

Early Recurrence ◽

Intrahepatic Metastasis ◽

High Rate ◽

Preoperative Imaging ◽

Curative Intent ◽

Initial Hepatectomy ◽

Cancer Spread

Hepatocellular carcinoma (HCC) shows a high rate of recurrence after hepatectomy; predictive factors for early recurrence would help determine optimal therapeutic and management strategies. Among 163 patients with HCC undergoing hepatectomy with curative intent, 46 patients developed recurrence within 1 year. Clinicopathological data were retrospectively analyzed to identify predictive parameters for early recurrence. Survival rates in cases of recurrence within 1 year were worse than those of no recurrence within 1 year or recurrence after 1 year. Protein induced by vitamin K absence/antagonist II (PIVKA-II) greater than 150, positive fucosylated alpha-fetoprotein (L3-AFP), and deviancy from Milan criteria (MC) on preoperative imaging were associated with high risk of early recurrence and total number of these three risk factors predicted the survival. With multivariate analysis, 1) preoperatively, positive factors of two or more among three items of PIVKA-II, L3-AFP, and deviancy from MC; 2) and postoperatively, pathological cancer spread (microscopic vascular invasion and/or intrahepatic metastasis) both represented risks for early recurrence. A combination of three preoperative factors, PIVKA-II, L3-AFP, and MC status, in conjunction with the postoperative factor of cancer spread status represents a significant indicator for recurrence within 1 year. Improving the prognosis of patients with HCC would depend on how to adequately treat those at high risk of early recurrence.

Download Full-text

Risk factors and patterns of early recurrence after curative hepatectomy for hepatocellular carcinoma

Surgical Oncology ◽

10.1016/j.suronc.2015.12.002 ◽

2016 ◽

Vol 25 (1) ◽

pp. 24-29 ◽

Cited By ~ 42

Author(s):

Fumitoshi Hirokawa ◽

Michihiro Hayashi ◽

Mitsuhiro Asakuma ◽

Tetsunosuke Shimizu ◽

Yoshihiro Inoue ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Early Recurrence ◽

Curative Hepatectomy

Download Full-text

Prognostic markers affecting the early recurrence of hepatocellular carcinoma with liver cirrhosis after curative resection

The International Journal of Biological Markers ◽

10.1177/1724600819834306 ◽

2019 ◽

Vol 34 (2) ◽

pp. 123-131 ◽

Cited By ~ 3

Author(s):

Wan-Joon Kim ◽

Tae-Wan Lim ◽

Pyoung-Jae Park ◽

Sae-Byeol Choi ◽

Wan-Bae Kim

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Liver Cirrhosis ◽

Survival Rate ◽

Curative Resection ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Early Recurrence ◽

Lymphocyte Ratio ◽

Recurrence Group

Background: Early recurrence is associated with poor prognosis after curative resection for hepatocellular carcinoma. Thus, we studied which factors, including this inflammation-based scoring system, affect disease recurrence in single hepatocellular carcinoma patients with liver cirrhosis. Methods: A total of 430 consecutive hepatocellular carcinoma patients were enrolled in our institution between January 2002 and December 2015. Survival rate, univariate, and multivariate analyses were performed to identify the variables associated with recurrence and early recurrence especially. Results: The overall survival rate was significantly lower in the early recurrence group than in the non-early recurrence group ( P<0.001). According to the multivariate analysis, protein induced by vitamin K absence or antagonist (PIVKA) greater than 200 ( P=0.035), neutrophil-to-lymphocyte ratio greater than 2.0 ( P<0.001), elevated Glasgow prognostic score ( P=0.003), tumor size greater than 5 cm ( P=0.002), and the presence of lymphovascular invasion ( P=0.002) were significantly different among the groups and affected the early recurrence of hepatocellular carcinoma. The patients were categorized into five levels of risk for early recurrence according to the number of independent risk factors, and patients with no risk factors were set as the reference group. Conclusion: Neutrophil-to-lymphocyte ratio, Glasgow prognostic score, and serum level of PIVKA offer significant prognostic information associated with early recurrence following single lesion hepatocellular carcinoma patients with liver cirrhosis after curative resection.

Download Full-text

TERT Mutations Correlated With the Prognosis of Patients With Hepatitis B-Related Hepatocellular Carcinoma Underwent Curative Hepatectomy

10.21203/rs.3.rs-283746/v1 ◽

2021 ◽

Author(s):

Kangjian Song ◽

Junyu Huo ◽

Fu He ◽

Qingwei Zhu ◽

Liqun Wu

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Overall Survival ◽

Hepatitis B ◽

Poor Prognosis ◽

Early Recurrence ◽

Single Factor ◽

Risk Factors For Recurrence ◽

Independent Risk Factors ◽

Curative Hepatectomy

Abstract Background To explore the value of TERT mutations in predicting the early recurrence and prognosis of hepatitis B-related hepatocellular carcinoma (HCC) patients underwent curative hepatectomy.Methods A total of 81 patients with hepatitis B-related HCC were enrolled and all patients underwent curative hepatectomy. Associations were sought between TERT mutations and recurrence rate within 2 years after hepatectomy, time to progress (TTP) and overall survival (OS).Results TERT mutations (HR: 2.985, 95%CI: 1.158-7.692, p=0.024) and Barcelona clinic liver (BCLC) stage B (HR: 3.326, 95%CI: 1.019-10.856, p=0.046) were independent risk factors for recurrence within 2 years after hepatectomy. Patients with a TERT mutation had poor TTP (p=0.003) and OS (p=0.013) than others. TERT mutations (HR: 2.245, 95%CI: 1.185-4.252, p=0.013) and BCLC stage B (HR: 2.132, 95%CI: 1.082-4.198, p=0.029) were independent risk factors for poor TTP after curative hepatectomy. A predictive model based on TERT mutations and BCLC stage had better ability to predict early recurrence after hepatectomy of HCC patients than any single factor (AUC: 0.688 vs. 0.639, 0.688 vs. 0.607, respectively). Patients with both TERT mutations and BCLC stage B had poorer TTP and OS than others (p=0.001, p<0.001, respectively).Conclusion TERT mutations had ability to predict early recurrence and poor prognosis for hepatitis B-related HCC patients underwent curative hepatectomy.

Download Full-text

Risk Factors for Early Recurrence of HBV-related Hepatocellular Carcinoma Meeting Milan Criteria after Curative Resection

Asian Pacific Journal of Cancer Prevention ◽

10.7314/apjcp.2013.14.12.7101 ◽

2013 ◽

Vol 14 (12) ◽

pp. 7101-7106 ◽

Cited By ~ 22

Author(s):

Wen-Jiang Zhu ◽

Chu-Ying Huang ◽

Chuan Li ◽

Wei Peng ◽

Tian-Fu Wen ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Curative Resection ◽

Early Recurrence ◽

Milan Criteria

Download Full-text

Predictive Value of Contrast-enhanced Ultrasound for Early Recurrence of Single Lesion Hepatocellular Carcinoma After Curative Resection

Ultrasonic Imaging ◽

10.1177/0161734618815231 ◽

2018 ◽

Vol 41 (1) ◽

pp. 49-58 ◽

Cited By ~ 1

Author(s):

Qin Xiachuan ◽

Zhou xiang ◽

Liu xuebing ◽

Luo yan

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Early Recurrence ◽

Maximum Diameter ◽

Washout Rate ◽

Feeding Artery ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced ◽

The Us ◽

Single Lesion

This retrospective study aimed to use preoperative and contrast-enhanced ultrasound (CEUS) factors to assess and reveal risk factors of early recurrence (ER) in patients with hepatocellular carcinoma (HCC). We enrolled 141 patients with primary HCC who had undergone surgical resection. The assessment of the CEUS scan includes (a) the maximum diameter of the lesion, (b) the tumor echogenicity of gray-scale ultrasound (US), (c) the morphology of the tumor, (d) the margin of the tumor, (e) the peripheral hypoechoic halo, (f) tumor necrosis, (g) nutritional arteries shown by tumors, (h) ultrasonography for diagnosis of cirrhosis, and (i) the timer on the US screen displayed the time elapsed from the saline flush and was used to determine time to washout. According to the degree of the phase, the washout rate is divided into four grades, namely, levels 1 to 4. ER is defined as the time between resection and recurrence within 12 months after surgery. Risk factors for ER HCC were analyzed. Predictors of ER on a univariate logistic regression analysis in CEUS are size, washout rate, morphology, center necrosis, and feeding artery appearing in the tumor. Multivariate analysis results indicated that feeding artery, microvascular invasion (MVI), and washout rate were independent risk factors for ER. The relative high risk of ER for washout rate 1, 2, 3, and 4 were 29.3%, 43.2%, 53.1%, and 71.4%, respectively. The appropriateness of hepatectomy in the treatment of single lesion HCC should be carefully considered when the washout rate was 4.

Download Full-text