Change in the Recurrence Pattern and Predictors over Time after Complete Cure of Hepatocellular Carcinoma
- Author:
Han Ah LEE
1
;
Young-Sun LEE
;
Beom Kyung KIM
;
Young Kul JUNG
;
Seung Up KIM
;
Jun Yong PARK
;
Ji Hoon KIM
;
Hyunggin AN
;
Do Young KIM
;
Hyung Joon YIM
;
Sang Hoon AHN
;
Jong Eun YEON
;
Kwan Soo BYUN
;
Kwang-Hyub HAN
;
Soon Ho UM
;
Yeon Seok SEO
Author Information
- Publication Type:Original Article
- From:Gut and Liver 2021;15(3):420-429
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:We investigated changes in recurrence rates and significant recurrence predictors over time after complete cure of hepatocellular carcinoma (HCC).
Methods:A total of 1,491 patients with first-time diagnosis of Barcelona Clinic Liver Cancer stage A HCC, completely cured by treatment between 2007 and 2016, were recruited from two Korean tertiary institutes.
Results:The mean age of the population (1,144 men and 347 women) was 58.6 years. Of the total population, 914 patients (61.3%) had liver cirrhosis. Nine-hundred and forty-one (63.1%) and 550 (36.9%) patients were treated with surgical resection and radiofrequency ablation (RFA), respectively. One-year cumulative incidences of HCC recurrence were 14.3%, 9.9%, and 5.1% from the time of treatment, 3 years after treatment, and 5 years after treatment, respectively. Upon multivariate analysis, multiple tumors, maximal tumor size ≥3 cm, and high Model for End-Stage Liver Disease scores were independently associated with increased HCC recurrence risk from the time of treatment and 1 and 2 years after curative treatment (all p<0.05, except for maxi-mal tumor size ≥3 cm for recurrence 2 years after treatment). Meanwhile, liver cirrhosis and RFA were independently associated with the increased HCC recurrence risk for almost all time points (liver cirrhosis: all p<0.05; RFA: all p<0.005 except for recurrence from 5 years after treatment).
Conclusions:The recurrence rate of HCC after curative treatment gradually decreased over time. Two years after treatment, when tumor-related factors lose their prognostic implications, may be used as a cutoff to define the boundary between early and late recurrence of HCC.
