The Management of Recurrence of Hepatocellular Carcinoma Occurring Within 6 Months After Hepatic Resection: A Comparative Study Using a Propensity Score Matching Analysis.

Abstract

BACKGROUND:

Hepatectomy is currently recommended as the most reliable treatment for hepatocellular carcinoma. However, the association between the choice of treatment for recurrence and the timing of recurrence remains controversial.

METHODS:

Three-hundred thirty-nine patients who underwent hepatectomy were retrospectively analyzed using a propensity score matching analysis for the risk factors and outcomes for early recurrences within 6 months. The remnant liver volumes and laboratory data were measured postoperatively using multidetector computed tomography on days 7 and months 1, 2, and 5 after surgery. The Student's t test and chi-square test, the likelihood-ratio test, Fisher's exact test, Mann-Whitney U test, or Wilcoxon signed-rank test were used in the statistical analyses.

RESULTS:

Early recurrence developed in 41/312 patients (13.1%). Vascular invasion and non-curative resection were independent risk factors for the occurrence of early recurrence (P < 0.001 and < 0.001, respectively). Patients with early recurrence had a poorer prognosis than patients who developed later recurrences (P < 0.001). Patients who underwent surgery or other local treatments had better outcomes (P < 0.001). The changes in remnant liver volumes and laboratory data after postoperative month 2 were not significantly different between the two groups.

CONCLUSION:

Patients with early recurrence within 6 months had a poorer prognosis than patients who developed a later recurrence. However, patients who underwent repeat hepatectomy for recurrences had a better prognosis than did those who underwent other treatments, with good prospects for long-term survival.

• Authors: Yoshihiro Inoue, Yusuke Suzuki, Masato Ota, Kazuya Kitada, Toru Kuramoto, Kensuke Fujii, Kentaro Matsuo, Yuta Miyaoka, Takahiro Miyamoto, Keisuke Yokohama, Hideko Ohama, Yoshiro Imai, Ryo Tanaka, Yusuke Tsuchimoto, Tetsuji Terazawa, Shinsuke Masubuchi, Masashi Yamamoto, Akira Asai, Yasutsugu Shirai, Masaya Inoue, Shinya Fukunishi, Yoshikatsu Nakahata, Michiaki Takii, Masahiro Goto, Fumiharu Kimura, Kazuhide Higuchi, Kazuhisa Uchiyama
• Journal: Journal of gastrointestinal cancer (J Gastrointest Cancer) Vol. 53 Issue 2 Pg. 272-281 (Jun 2022) ISSN: 1941-6636 [Electronic] United States
• PMID: 33471258 (Publication Type: Journal Article)
• Copyright: © 2021. Springer Science+Business Media, LLC, part of Springer Nature.

Topics

• Carcinoma, Hepatocellular (pathology)
• Hepatectomy (methods)
• Humans
• Liver Neoplasms (pathology)
• Neoplasm Recurrence, Local (epidemiology, surgery)
• Prognosis
• Propensity Score
• Recurrence
• Retrospective Studies