Early recurrence of hepatocellular carcinoma after curative intent surgical resection – Risk factors & Recurrence patterns.

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.

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Exploration of preoperative risk factors for early recurrence in patients with resectable pancreatic ductal adenocarcinoma after curative intent surgical resection

Pancreatology ◽

10.1016/j.pan.2017.07.042 ◽

2017 ◽

Vol 17 (4) ◽

pp. S12

Author(s):

Hong Joo kim

Keyword(s):

Risk Factors ◽

Pancreatic Ductal Adenocarcinoma ◽

Surgical Resection ◽

Early Recurrence ◽

Ductal Adenocarcinoma ◽

Preoperative Risk ◽

Curative Intent ◽

Preoperative Risk Factors

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Early recurrence after radiofrequency ablation for hepatocellular carcinoma: a multicenter retrospective study on definition, patterns and risk factors

International Journal of Hyperthermia ◽

10.1080/02656736.2020.1849828 ◽

2021 ◽

Vol 38 (1) ◽

pp. 437-446

Author(s):

Yi Yang ◽

Yujing Xin ◽

Feng Ye ◽

Ning Liu ◽

Xinyuan Zhang ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Retrospective Study ◽

Radiofrequency Ablation ◽

Early Recurrence

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Inflammatory indexes in preoperative blood routine to predict early recurrence of hepatocellular carcinoma after curative hepatectomy

BMC Surgery ◽

10.1186/s12893-021-01180-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

YiFeng Wu ◽

ChaoYong Tu ◽

ChuXiao Shao

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Tumour Size ◽

Area Under The Curve ◽

Early Recurrence ◽

Recurrence Free Survival ◽

Free Survival ◽

Lymphocyte Ratio ◽

Inflammatory Index ◽

Curative Hepatectomy

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.

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Ezrin expression is associated with hepatocellular carcinoma possibly derived from progenitor cells and early recurrence after surgical resection

Modern Pathology ◽

10.1038/modpathol.2008.59 ◽

2008 ◽

Vol 21 (7) ◽

pp. 847-855 ◽

Cited By ~ 25

Author(s):

Daiki Okamura ◽

Masayuki Ohtsuka ◽

Fumio Kimura ◽

Hiroaki Shimizu ◽

Hiroyuki Yoshidome ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Progenitor Cells ◽

Surgical Resection ◽

Early Recurrence ◽

Ezrin Expression

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Surgical Resection Significantly Promotes the Overall Survival of Patients with Hepatocellular Carcinoma: A Propensity Score Matching Analysis

10.21203/rs.3.rs-148506/v1 ◽

2021 ◽

Author(s):

Pei-Min Hsieh ◽

Hung-Yu Lin ◽

Chao-Ming Hung ◽

Gin-Ho Lo ◽

I-Cheng Lu ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Overall Survival ◽

Propensity Score ◽

Propensity Score Matching ◽

Surgical Resection ◽

Cox Regression ◽

Survival Rates ◽

Hbv Infection ◽

Cox Regression Analysis

Abstract Background: The benefits of surgical resection (SR) for various Barcelona Clinic Liver Cancer (BCLC) stages of hepatocellular carcinoma (HCC) remain unclear. We investigated the risk factors of overall survival (OS) and survival benefits of SR over nonsurgical treatments in patients with HCC of various BCLC stages.Methods: Overall, 2316 HCC patients were included, and their clinicopathological data and OS were recorded. OS was analyzed by the Kaplan-Meier method and Cox regression analysis. Propensity score matching (PSM) analysis was performed.Results: In total, 66 (2.8%), 865 (37.4%), 575 (24.8%) and 870 (35.0%) patients had BCLC stage 0, A, B, and C disease, respectively. Furthermore, 1302 (56.2%) of all patients, and 37 (56.9%), 472 (54.6%), 313 (54.4%) and 480 (59.3%) of patients with BCLC stage 0, A, B, and C disease, respectively, died. The median follow-up duration time was 20 (range 0-96) months for the total cohort and was subdivided into 52 (8-96), 32 (1-96), 19 (0-84), and 12 (0-79) months for BCLC stages 0, A, B, and C cohorts, respectively. The risk factors for OS were 1) SR and cirrhosis; 2) SR, cirrhosis, and Child-Pugh (C-P) class; 3) SR, hepatitis B virus (HBV) infection, and C-P class; and 4) SR, HBV infection, and C-P class for the BCLC stage 0, A, B, and C cohorts, respectively. Compared to non-SR treatment, SR resulted in significantly higher survival rates in all cohorts. The 5-year OS rates for SR vs non-SR were 44.0% vs 28.7%, 72.2% vs 42.6%, 42.6% vs 36.2, 44.6% vs 23.5%, and 41.4% vs 15.3% (all p-values<0.05) in the total and BCLC stage 0, A, B, and C cohorts, respectively. After PSM, SR resulted in significantly higher survival rates compared to non-SR treatment in various BCLC stages.Conclusion: SR conferred significant survival benefits to patients with HCC of various BCLC stages and should be considered a recommended treatment for select HCC patients, especially patients with BCLC stage B and C disease.

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

HPB ◽

10.1016/j.hpb.2018.02.327 ◽

2018 ◽

Vol 20 ◽

pp. S83-S84

Author(s):

R. Simon ◽

K. Sasaki ◽

Georgios A. Margonis ◽

Jin He ◽

L. Acevedo-Moreno ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Retrospective Review ◽

Early Recurrence

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Role of Sorafenib in Patients With Recurrent Hepatocellular Carcinoma After Liver Transplantation

Progress in Transplantation ◽

10.1177/1526924816664083 ◽

2016 ◽

Vol 26 (4) ◽

pp. 348-355 ◽

Cited By ~ 13

Author(s):

Nicola de’Angelis ◽

Filippo Landi ◽

Marco Nencioni ◽

Anais Palen ◽

Eylon Lahat ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

Survival Rates ◽

Early Recurrence ◽

Best Supportive Care ◽

Curative Intent ◽

Sorafenib Group ◽

Hepatocellular Carcinoma Recurrence ◽

Retrospective Comparative Study ◽

Hcc Recurrence

Context: The management of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) is challenging, especially if it is not treatable by surgery or embolization. Objectives: The present study aims to compare the survival rates of liver transplanted patients receiving sorafenib or best supportive care (BSC) for HCC recurrence not amenable to curative intent treatments. Design: This is a retrospective comparative study on a prospectively maintained database. Participants: Liver transplanted patients with untreatable HCC recurrence receiving BSC (n = 18) until 2007 or sorafenib (n = 15) thereafter were compared. Results: No group difference was observed for demographic characteristics at the time of transplantation and at the time of HCC recurrence. On the explant pathology of the native liver, 81.2% patients were classified within the Milan criteria, and 53.1% presented with microvascular invasion. Hepatocellular carcinoma recurrence was diagnosed 17.8 months (standard deviation: 14.5) after LT, with 17 (53.1%) patients presenting with early recurrence (≤12 months). The 1-year survival from untreatable progression of HCC recurrence was 23.9% for the BSC and 60% for the sorafenib group ( P = .002). The type of treatment (sorafenib vs BSC) was the sole independent predictor of survival (hazard ratio: 2.98; 95% confidence interval: 1.09-8.1; P = .033). In the sorafenib group, 8 (53.3%) patients required dose reduction, and 2 (13.3%) patients discontinued the treatment due to intolerable side effects. Conclusion: Sorafenib improves survival and is superior to the BSC in cases of untreatable posttransplant hepatocellular carcinoma recurrence.

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